OBJECTIVE: To determine whether nasal bridling is a low-morbidity practice that decreases feeding tube dislodgment and results in improved caloric intake. DESIGN: Randomized, controlled trial. SETTING:Private, tertiary-care referral center. PATIENTS: A total of 80 surgical intensive care unit patients requiring nasojejunal feeding. INTERVENTION: Nasal bridling of feeding tubes. MEASUREMENTS AND MAIN RESULTS:Between January 1, 2008 and July 31, 2008, 80 patients were randomized to have their nasojejunal feeding tubes secured with either a nasal bridle or an adhesive device. Baseline characteristics examined included age, sex, concurrent nasogastric tube presence, primary diagnosis, Acute Physiology and Chronic Health Evaluation III score, need for mechanical ventilation, need for emergent surgery, Riker Sedation Score, and Glascow Coma Scale. Patients were monitored daily for prevalence and cause of feeding tube removal, percentage of goal calories received, nasal ulceration, and sinusitis. Serum albumin and prealbumin levels were collected weekly. All patients were examined, using an intention-to-treat design. Except for a higher prevalence of emergent surgery in the bridled patients, the bridled and unbridled groups had no difference in baseline characteristics. Bridled tubes were less likely to be unintentionally dislodged than unbridled tubes (18% vs. 63%, p < .0001) resulting in bridled patients receiving a higher percentage of goal calories (median 78% [interquartile range, 65%-86%] vs. 62% [interquartile range, 47%-80%], p = .016) than unbridled patients. There were five cases of mild epistaxis upon bridle insertion and four cases of superficial nasal ulceration associated with the bridle. No bridled patients were diagnosed with sinusitis during the study period. Serum albumin and prealbumin levels did not differ between the groups. CONCLUSIONS: Bridling of nasoenteric feeding tubes in critically ill patients is a low-morbidity practice that reduces the rate of unintentional tube dislodgment and may result in improved caloric intake.
RCT Entities:
OBJECTIVE: To determine whether nasal bridling is a low-morbidity practice that decreases feeding tube dislodgment and results in improved caloric intake. DESIGN: Randomized, controlled trial. SETTING: Private, tertiary-care referral center. PATIENTS: A total of 80 surgical intensive care unit patients requiring nasojejunal feeding. INTERVENTION: Nasal bridling of feeding tubes. MEASUREMENTS AND MAIN RESULTS: Between January 1, 2008 and July 31, 2008, 80 patients were randomized to have their nasojejunal feeding tubes secured with either a nasal bridle or an adhesive device. Baseline characteristics examined included age, sex, concurrent nasogastric tube presence, primary diagnosis, Acute Physiology and Chronic Health Evaluation III score, need for mechanical ventilation, need for emergent surgery, Riker Sedation Score, and Glascow Coma Scale. Patients were monitored daily for prevalence and cause of feeding tube removal, percentage of goal calories received, nasal ulceration, and sinusitis. Serum albumin and prealbumin levels were collected weekly. All patients were examined, using an intention-to-treat design. Except for a higher prevalence of emergent surgery in the bridled patients, the bridled and unbridled groups had no difference in baseline characteristics. Bridled tubes were less likely to be unintentionally dislodged than unbridled tubes (18% vs. 63%, p < .0001) resulting in bridled patients receiving a higher percentage of goal calories (median 78% [interquartile range, 65%-86%] vs. 62% [interquartile range, 47%-80%], p = .016) than unbridled patients. There were five cases of mild epistaxis upon bridle insertion and four cases of superficial nasal ulceration associated with the bridle. No bridled patients were diagnosed with sinusitis during the study period. Serum albumin and prealbumin levels did not differ between the groups. CONCLUSIONS: Bridling of nasoenteric feeding tubes in critically illpatients is a low-morbidity practice that reduces the rate of unintentional tube dislodgment and may result in improved caloric intake.
Authors: Lena B Palmer; Stephen A McClave; Matthew L Bechtold; Douglas L Nguyen; Robert G Martindale; David C Evans Journal: Curr Gastroenterol Rep Date: 2014-10
Authors: Luiz Gonzaga Torres Júnior; Fernando Augusto de Vasconcellos Santos; Maria Isabel Toulson Davisson Correia Journal: World J Surg Date: 2014-09 Impact factor: 3.352
Authors: Matthew L Bechtold; Douglas L Nguyen; Lena B Palmer; Laszlo N Kiraly; Robert G Martindale; Stephen A McClave Journal: Nutr Clin Pract Date: 2014-10 Impact factor: 3.080
Authors: Arja Gerritsen; Marc G Besselink; Kasia P Cieslak; Menno R Vriens; Elles Steenhagen; Richard van Hillegersberg; Inne H Borel Rinkes; I Quintus Molenaar Journal: J Gastrointest Surg Date: 2012-04-20 Impact factor: 3.452
Authors: Carmen Sílvia Valente Barbas; Alexandre Marini Ísola; Augusto Manoel de Carvalho Farias; Alexandre Biasi Cavalcanti; Ana Maria Casati Gama; Antonio Carlos Magalhães Duarte; Arthur Vianna; Ary Serpa Neto; Bruno de Arruda Bravim; Bruno do Valle Pinheiro; Bruno Franco Mazza; Carlos Roberto Ribeiro de Carvalho; Carlos Toufen Júnior; Cid Marcos Nascimento David; Corine Taniguchi; Débora Dutra da Silveira Mazza; Desanka Dragosavac; Diogo Oliveira Toledo; Eduardo Leite Costa; Eliana Bernadete Caser; Eliezer Silva; Fabio Ferreira Amorim; Felipe Saddy; Filomena Regina Barbosa Gomes Galas; Gisele Sampaio Silva; Gustavo Faissol Janot de Matos; João Claudio Emmerich; Jorge Luis dos Santos Valiatti; José Mario Meira Teles; Josué Almeida Victorino; Juliana Carvalho Ferreira; Luciana Passuello do Vale Prodomo; Ludhmila Abrahão Hajjar; Luiz Claudio Martins; Luis Marcelo Sá Malbouisson; Mara Ambrosina de Oliveira Vargas; Marco Antonio Soares Reis; Marcelo Brito Passos Amato; Marcelo Alcântara Holanda; Marcelo Park; Marcia Jacomelli; Marcos Tavares; Marta Cristina Paulette Damasceno; Murillo Santucci César Assunção; Moyzes Pinto Coelho Duarte Damasceno; Nazah Cherif Mohamed Youssef; Paulo José Zimmermann Teixeira; Pedro Caruso; Péricles Almeida Delfino Duarte; Octavio Messeder; Raquel Caserta Eid; Ricardo Goulart Rodrigues; Rodrigo Francisco de Jesus; Ronaldo Adib Kairalla; Sandra Justino; Sergio Nogueira Nemer; Simone Barbosa Romero; Verônica Moreira Amado Journal: Rev Bras Ter Intensiva Date: 2014 Jul-Sep