Nursing Graduate Program, Federal University of Rio Grande do Norte, Natal, Brazil.
Department of Nursing, Federal University of Rio Grande do Norte, Natal, Brazil.
Medicine (Baltimore). 2023 May 19;102(20):e33795. doi: 10.1097/MD.0000000000033795.
despite being a common procedure, nasally placed small-bowel feeding tube insertion is not risk-free and can compromise patient safety. Due to the fact that nasally placed small-bowel feeding tube is commonly inserted '"blindly," with the patient head in the neutral position, sometimes the process becomes difficult and traumatic, and may present higher level of complexity in physiological or induced coma and intubated patients. Therefore, adverse events (AEs) route errors can occur during this procedure. This study aimed to determine the effectiveness of different nasally placed small-bowel feeding tube insertion techniques in coma and intubated patients, in comparison with conventional method.
A prospective, randomized and controlled clinical trial will be carried out with coma and intubated patients admitted to the Intensive Care Unit (ICU). Thirty-nine patients will be randomly divided into 3 groups: group who will have the tube inserted in a conventional manner with the head in the neutral position, group with the head positioned laterally to the right, and, finally, with the head in the neutral position, with assistance of a laryngoscope. The primary endpoint will be: first, second and total attempt success rate; and time required for the first successful attempt and the sum of all attempts. Complications during insertion included tube bending, twisting, knotting, mucosal bleeding, and insertion into the trachea. Patient vital signs will be measured.
尽管鼻饲小肠喂养管插入是一种常见的操作，但并非没有风险，可能会危及患者安全。由于鼻饲小肠喂养管通常是在患者头部处于中立位的情况下“盲目”插入的，有时这个过程会变得困难和具创伤性，并且在生理或诱导性昏迷和插管患者中可能会呈现更高的复杂性水平。因此，在这个过程中可能会发生不良事件（AE）路径错误。本研究旨在确定在昏迷和插管患者中与传统方法相比，不同的鼻饲小肠喂养管插入技术的效果。
将对入住重症监护病房（ICU）的昏迷和插管患者进行前瞻性、随机和对照临床试验。将 39 名患者随机分为 3 组：常规方法组，头处于中立位；右侧头侧位组；以及头处于中立位，使用喉镜辅助组。主要终点将是：首次、第二次和总尝试成功率；以及首次成功尝试所需的时间和所有尝试的总和。插入过程中的并发症包括管弯曲、扭转、打结、黏膜出血和插入气管。将测量患者生命体征。
