Taylor Stephen J, Sayer Kaylee, White Paul
Department of Nutrition and Dietetics, Southmead Hospital Bristol, Bristol, UK.
Mathematics and Statistics Research Group, University of the West of England, Bristol, UK.
J Intensive Care Soc. 2023 Feb;24(1):62-70. doi: 10.1177/17511437221095336. Epub 2022 May 27.
Delayed gastric emptying (DGE) is a major cause of undernutrition that can be overcome using nasointestinal (NI) feeding, but tube placement often fails. We analyse which techniques enable successful NI tube placement.
Efficacy of tube technique was determined at each of six anatomical points: Nose, nasopharynx-oesophagus, stomach-upper and -lower, duodenum part-1 and intestine.
In 913 first NI tube placements, significant associations with tube advancement were found in the pharynx (head tilt, jaw thrust, laryngoscopy), stomach_upper (air insufflation, 10 cm or 20-30 cm flexible tube tip ± reverse Seldinger manoeuvre), stomach_lower (air insufflation, possibly flexible tip and wire stiffener) and duodenum part-1 and beyond part-2 (flexible tip and combinations of micro-advance, slack removal, wire stiffener or prokinetic drugs).
This is the first study to show what techniques are associated with tube advancement and the alimentary tract level they are specific to.
胃排空延迟（DGE）是营养不良的主要原因，可通过鼻肠（NI）喂养克服，但置管常失败。我们分析哪些技术能成功进行NI置管。
在六个解剖部位（鼻、鼻咽-食管、胃上、胃下、十二指肠第1部和肠道）分别确定置管技术的有效性。
在913例首次NI置管中，发现咽部（头部倾斜、下颌前推、喉镜检查）、胃上（注气、10 cm或20 - 30 cm可弯曲管尖±改良塞丁格技术）、胃下（注气、可能需要可弯曲管尖和导丝加强器）以及十二指肠第1部及以后的第2部（可弯曲管尖以及微推进、去除松弛、导丝加强器或促动力药物的组合）与置管推进显著相关。
这是第一项表明哪些技术与置管推进相关以及它们所特定针对的消化道水平的研究。
