Electromagnetic-Guided Bedside Placement of Nasoenteral Feeding Tubes by Nurses Is Non-Inferior to Endoscopic Placement by Gastroenterologists: A Multicenter Randomized Controlled Trial
| Autor: | Arja Gerritsen, Dirk Jan Bac, Marcel G. W. Dijkgraaf, Elisabeth M Mathus-Vliegent, Camiel Rosman, Adriaan C.I.T.L. Tan, Jan F. Monkelbaan, Olivier R. Busch, Dirk T. Ubbink, Mariël Klos, Jacques J. Bergman, Philip M Kruyt, Peter van Duijvendijk, Marc G. Besselink, G. Willemien Erkelens, I. Quintus Molenaar, Thijs de Rooij |
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| Přispěvatelé: | Other departments, Clinical Research Unit, Surgery, Gastroenterology and Hepatology, Patient Care Support |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Gastroparesis Point-of-Care Systems medicine.medical_treatment Nurses law.invention 03 medical and health sciences Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] Enteral Nutrition Ileus Postoperative Complications 0302 clinical medicine Randomized controlled trial law Journal Article medicine Humans Intubation Endoscopy Digestive System 030212 general & internal medicine Intubation Gastrointestinal Aged Hepatology medicine.diagnostic_test business.industry Gastroenterologists Malnutrition Gastroenterology Middle Aged Surgery Endoscopy Multicenter Study Pancreatitis Multicenter study Randomized Controlled Trial Magnets Female 030211 gastroenterology & hepatology business |
| Zdroj: | American journal of gastroenterology, 111(8), 1123-1132. Springer Nature American Journal of Gastroenterology, 111, 8, pp. 1123-32 American Journal of Gastroenterology, 111, 1123-32 American Journal of Gastroenterology, 111(8), 1123. Nature Publishing Group |
| ISSN: | 0002-9270 |
| Popis: | Item does not contain fulltext OBJECTIVES: Electromagnetic (EM)-guided bedside placement of nasoenteral feeding tubes by nurses may improve efficiency and reduce patient discomfort and costs compared with endoscopic placement by gastroenterologists. However, evidence supporting this task shift from gastroenterologists to nurses is limited. We aimed to compare the effectiveness of EM-guided and endoscopic nasoenteral feeding tube placement. METHODS: We performed a multicenter randomized controlled non-inferiority trial in 154 adult patients who required nasoenteral feeding and were admitted to gastrointestinal surgical wards in five Dutch hospitals. Patients were randomly assigned (1:1) to undergo EM-guided or endoscopic nasoenteral feeding tube placement. The primary end point was the need for reinsertion of the feeding tube (e.g., after failed initial placement or owing to tube-related complications) with a prespecified non-inferiority margin of 10%. RESULTS: Reinsertion was required in 29 (36%) of the 80 patients in the EM-guided group and 31 (42%) of the 74 patients in the endoscopy group (absolute risk difference -6%, upper limit of one-sided 95% confidence interval 7%; P for non-inferiority=0.022). No differences were noted in success and complication rates. In the EM-guided group, there was a reduced time to start of feeding (424 vs. 535 min, P=0.001). Although the level of discomfort was higher in the EM-guided group (Visual Analog Scale (VAS) 3.9 vs. 2.0, P=0.009), EM-guided placement received higher recommendation scores (VAS 8.2 vs. 5.5, P=0.008). CONCLUSIONS: EM-guided bedside placement of nasoenteral feeding tubes by nurses was non-inferior to endoscopic placement by gastroenterologists in surgical patients and may be considered the preferred technique for nasoenteral feeding tube placement. |
| Databáze: | OpenAIRE |
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