Camacho F, Humm K
Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, West Midlands, B90 4NH, UK.
Queen Mother Hospital for Animals, The Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, AL9 7TA, UK.
J Small Anim Pract. 2024 Jul;65(7):417-423. doi: 10.1111/jsap.13729. Epub 2024 May 1.
To determine the rate of accidental placement of nasoenteric tubes into the respiratory tract. To compare the methods of checking correct tube placement. To compare the complication rates between nasoesophageal and nasogastric tubes.
Animals requiring nasoenteric feeding tubes were prospectively randomised to have either nasoesophageal or nasogastric tube placement. Various techniques for assessing tube position were compared with thoracic radiographic findings. Complications during placement and use were recorded.
Ninety-seven animals (82 dogs and 15 cats) were studied. The tube was misplaced into the respiratory tract in three (3.1%) cases. No technique for checking placement was completely concordant with radiography but the presence of negative pressure at the thoracic inlet during placement was consistent with the presence of the tube in the oesophagus in 86.2% cases, while capnography can be considered to confirm tracheal placement. The overall rate of complications during tube placement was 25.8%, with mostly minor clinical complications reported. There was no significant difference in the new-onset regurgitation/vomiting rate, or complications while the tube was in situ between the nasoesophageal and nasogastric groups.
Misplacement of nasoenteric tubes is uncommon but a consistent alternative test to radiography for checking correct nasoenteric tube placement was not demonstrated. The choice of placement of either a nasoesophageal or nasogastric tube should be guided by clinician preference, and clients should be warned about possible complications during placement and while the nasoenteric tube is in situ.
确定鼻肠管意外置入呼吸道的发生率。比较检查鼻肠管正确位置的方法。比较鼻饲管和鼻胃管的并发症发生率。
前瞻性随机选取需要鼻肠饲管的动物,分别置入鼻饲管或鼻胃管。将评估导管位置的各种技术与胸部X线检查结果进行比较。记录置管和使用过程中的并发症。
共研究了97只动物(82只狗和15只猫)。有3例(3.1%)导管误置入呼吸道。没有一种检查置管位置的技术与X线检查完全一致,但置管时胸廓入口处出现负压在86.2%的情况下与导管位于食管内相符,而二氧化碳监测可用于确认气管内置管。置管期间并发症的总发生率为25.8%,报告的大多为轻微临床并发症。鼻饲管组和鼻胃管组在新出现的反流/呕吐发生率或导管在位时的并发症方面无显著差异。
鼻肠管误置并不常见,但未证实有一种能始终替代X线检查用于检查鼻肠管正确位置的方法。鼻饲管或鼻胃管的选择应根据临床医生的偏好来指导,并且应告知患者置管期间以及鼻肠管在位时可能出现的并发症。