Blind versus endoscopy-guided postpyloric feeding tube placement in adults with ischemic stroke: A retrospective cohort study.

Autor: Sun C; Neurology Intensive Care Unit, Wuhan Hospital of Traditional Chinese and Western Medicine, Wuhan, China.; Neurology Intensive Care Unit, Wuhan No 1 Hospital, Wuhan, China., Yuan K; The College of Post and Telecommunication, Wuhan Institute of Technology, Wuhan, China., Gao Q; Manchester Metropolitan Joint Institute, Hubei University, Wuhan, China., Liu F; Neurology Intensive Care Unit, Wuhan Hospital of Traditional Chinese and Western Medicine, Wuhan, China.; Neurology Intensive Care Unit, Wuhan No 1 Hospital, Wuhan, China., Long Y; Neurology Intensive Care Unit, Wuhan Hospital of Traditional Chinese and Western Medicine, Wuhan, China.; Neurology Intensive Care Unit, Wuhan No 1 Hospital, Wuhan, China., Wang L; Nursing Department, Wuhan Hospital of Traditional Chinese and Western Medicine, Wuhan, China.; Nursing Department, Wuhan No 1 Hospital, Wuhan, China.
Jazyk: angličtina
Zdroj: JPEN. Journal of parenteral and enteral nutrition [JPEN J Parenter Enteral Nutr] 2024 Jul; Vol. 48 (5), pp. 597-604. Date of Electronic Publication: 2024 May 28.
DOI: 10.1002/jpen.2645
Abstrakt: Background: This study compared the one-time success rate of blind and endoscopy-guided postpyloric feeding tube placement after implementing a comprehensive nursing scheme of intestinal blind placement for patients with ischemic stroke.
Methods: This retrospective cohort study included 179 patients with blind bedside placement and 118 with endoscopy-guided placement. The primary outcome was the one-time success rate of radiologically confirmed postpyloric placement. The secondary endpoints included the position of the tube tip, length of insertion, time of placement, and expenses. The safety endpoints were the incidence of complications caused by placement.
Results: The results showed that the method of tube placement did not significantly affect the outcome of the first tube placement (odds ratio [OR] = 0.41; 95% CI = 0.137-1.207; P = 0.105). Compared with endoscopy-guided placement, blind placement was half the cost. We also found that a history of abdominal surgery (OR = 0.003; 95% CI  = 0.000-0.059; P < 0.001) and longer intensive care unit (ICU) days (OR = 0.94; 95% CI = 0.903-0.981; P = 0.004) were inversely associated with the one-time success rate.
Conclusion: Our study suggested that blind intestinal feeding tube placement has an equivalent one-time success rate compared with endoscopy-guided placement in hospitalized patients with ischemic stroke if operators can be trained well. However, the expenses of endoscopy-guided placement were twice those of blind bedside methods. We also found that patients with abdominal surgery history and longer ICU stay were more likely to fail at the first placement. Further research is needed to replicate our single-center observations in a larger population of patients.
(© 2024 American Society for Parenteral and Enteral Nutrition.)
Databáze: MEDLINE
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