RESUMO
OBJECTIVE: To investigate a novel method of bedside placement of post-pyloric feeding tubes in critically ill patients, and to evaluate its success rate, time used, and safety of this bedside method. METHODS: Data of consecutive patients requiring post-pyloric feeding from February 2009 to July 2009 were collected. In this new method, a non weighted 130-cm-long nasoenteric feeding tube with a guide wire was used under 10 mg of intravenous metoclopramide. The tube was gradually advanced, and the position of the tube was confirmed by auscultation to detect bubbling sound and respiration of inflated air (the vacuum test), as well as pH measurement of aspirated fluid. An abdominal radiograph was made finally for confirmation of the position of the tube before the feeding was initiated. The time taken to insert the tube, the success rate, the time between the decision to feed and commencement of feeding, and the complications of the procedure were recorded. RESULTS: In 28 patients the post-pyloric feeding tube was placed. The main indication was 18 cases with high risk of aspiration, 3 with gastroparesis, and 7 with acute pancreatitis. Of the 28 tube placements performed, 26 (92.9%) were successful, and in 21 (75.0% of 28) the tube was in the jejunum. The average time for successful placement was (20.36+/-6.41) minutes. The time between the decision for feeding and commencement of feeding was (4.15+/-1.68) hours. No complications occurred. CONCLUSION: Using a conventional nasoenteric feeding tube with a guide wire, and only one medical staff needed for the placement of the tube, this method is an efficient and cost-effective method of bedside post-pyloric feeding tube placement.
