A novel technique for nasoduodenal feeding tube placement in critically ill patients

Introduction

Although enteral nutrition is considered superior to parenteral nutrition in critically ill patients, it is frequently delayed or prevented by gastroparesis. A variety of approaches have been developed to bypass the stomach, but none has proved entirely satisfactory. The Cathlocator^- is a novel device that permits real time localization of the end of feeding tubes by detection of a magnetic field generated by a small electric current in a coil in the tip of the tube. It is portable, can be used at the bedside and uses no ionizing radiation.

Study objective

To evaluate placement of tubes for (i) nasoduodenal feeding, and (ii) nasogastric drainage in critically ill patients using the Cathlocator^-.

Methods

Ten nasoduodenal tube placements were attempted in nine critically ill patients. The Cathlocator^- was used to guide positioning of the tube beyond the pylorus and also to determine whether a separate nasogastric tube was placed correctly. Tube tip position was confirmed by plain abdominal X-ray. Data are median and range.

Results

Nasoduodenal tube placement was successful in 9 of 10 attempts (insertion time 14.5 min [5.0-34.4]). All nasogastric tube placements were successful (insertion time 4.4 min [0.8-9.5]). The Cathlocator^- accurately determined the position of both tubes in all cases. There were no complications.

Conclusion

The Cathlocator^- accurately gives the location of an enteral tube in real time. It thus provides an effective bedside technique for nasoduodenal tube placement to facilitate enteral feeding in critically ill patients.

This study was partially funded by Micronix Pty Ltd.