Xuejin Gao1, Li Zhang1, Jie Zhao2, Feng Tian1, Haifeng Sun1, Peng Wang1, Jiwei Wang1, Zhiming Wang3, Xinying Wang4. 1. Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China. 2. Department of Neurosurgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China. 3. Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China. Electronic address: drwangzhiming@126.com. 4. Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China. Electronic address: wxinying@263.net.
Abstract
PURPOSE: We aimed to compare the effectiveness of EM-guided and endoscopic nasoenteral feeding tube placement among critically ill patients. MATERIALS AND METHODS: We performed a single-center, randomized controlled trial among 161 adult patients admitted to intensive care units (ICUs) requiring nasoenteral feeding. Patients were randomly assigned to EM-guided or endoscopic nasoenteral feeding tube placement (1:1). The primary end point was the total success rate of correct jejunal placement. RESULTS: This was achieved in 74/81 and 76/80 patients who underwent EM-guided and endoscopic jejunal tube placements, respectively (91.4% vs. 95%; relative risk, 0.556; [CI], 0.156-1.980; P = 0.360). The EM-guided group had more placement attempts, longer placement time, and shorter inserted nasal intestinal tube length. However, they had shorter total placement procedure duration and physician's order-tube placement and order-start of feeding intervals. The EM-guided group had higher discomfort level and recommendation scores and lesser patient costs. This trial is registered at Chinese Clinical Trials Registry (ChiCTR-IOR-17011737). CONCLUSION:Bedside EM-guided placement is as fast, safe, and successful as endoscopic placement and may be considered the preferred technique in critically ill patients.
RCT Entities:
PURPOSE: We aimed to compare the effectiveness of EM-guided and endoscopic nasoenteral feeding tube placement among critically illpatients. MATERIALS AND METHODS: We performed a single-center, randomized controlled trial among 161 adult patients admitted to intensive care units (ICUs) requiring nasoenteral feeding. Patients were randomly assigned to EM-guided or endoscopic nasoenteral feeding tube placement (1:1). The primary end point was the total success rate of correct jejunal placement. RESULTS: This was achieved in 74/81 and 76/80 patients who underwent EM-guided and endoscopic jejunal tube placements, respectively (91.4% vs. 95%; relative risk, 0.556; [CI], 0.156-1.980; P = 0.360). The EM-guided group had more placement attempts, longer placement time, and shorter inserted nasal intestinal tube length. However, they had shorter total placement procedure duration and physician's order-tube placement and order-start of feeding intervals. The EM-guided group had higher discomfort level and recommendation scores and lesser patient costs. This trial is registered at Chinese Clinical Trials Registry (ChiCTR-IOR-17011737). CONCLUSION: Bedside EM-guided placement is as fast, safe, and successful as endoscopic placement and may be considered the preferred technique in critically illpatients.
Authors: Fabio Catache Mancini; Diogo Turiani Hourneaux de Moura; Mateus Pereira Funari; Igor Braga Ribeiro; Fernando Lopes Ponte Neto; Pastor Joaquin Ortiz Mendieta; Thomas R McCarty; Wanderley Marques Bernardo; Sergio Carlos Nahas; Eduardo Guimarães Hourneaux de Moura Journal: Endosc Int Open Date: 2022-08-15