Progression rate of self-propelled feeding tubes in critically ill patients.

Détails

ID Serval
serval:BIB_47D807C716E6
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Progression rate of self-propelled feeding tubes in critically ill patients.
Périodique
Intensive care medicine
Auteur(s)
Berger M.M., Bollmann M.D., Revelly J.P., Cayeux M.C., Pilon N., Bracco D., Chioléro R.L.
ISSN
0342-4642
Statut éditorial
Publié
Date de publication
2002
Peer-reviewed
Oui
Volume
28
Numéro
12
Pages
1768-1774
Langue
anglais
Notes
Publication types: Clinical Trial ; Journal Article - Publication Status: ppublish
Résumé
OBJECTIVE: Gaining postpyloric access in ventilated, sedated ICU patients usually requires time-consuming procedures such as endoscopy. Recently, a feeding tube has been introduced that migrates spontaneously into the jejunum in surgical patients. The study aimed at assessing the rate of migration of this tube in critically ill patients. DESIGN: Prospective descriptive trial. SETTING: Surgical ICU in a tertiary University Hospital. PATIENTS: One hundred and five consecutive surgical ICU patients requiring enteral feeding were enrolled, resulting in 128 feeding-tube placement attempts. METHODS: A self-propelled tube was used and followed up for 3 days: progression was assessed by daily contrast-injected X-ray. Severity of illness was assessed with SAPS II and organ failure assessed with SOFA score. RESULTS: The patients were aged 55+/-19 years (mean+/-SD) with SAPS II score of 45+/-18. Of the 128 tube placement attempts, 12 could not be placed in the stomach; eight were accidentally pulled out while in gastric position due to the necessity to avoid fixation during the progression phase. Among organ failures, respiratory failure predominated, followed by cardiovascular. By day 3, the postpyloric progression rate was 63/128 tubes (49%). There was no association between migration and age, or SAPS II score, but the progression rate was significantly poorer in patients with hemodynamic failure. Use of norepinephrine and morphine were negatively associated with tube progression (P<0.001), while abdominal surgery was not. In ten patients, jejunal tubes were placed by endoscopy. CONCLUSION: Self-propelled feeding tubes progressed from the stomach to the postpyloric position in 49% of patients, reducing the number of endoscopic placements: these tubes may facilitate enteral nutrient delivery in the ICU.
Mots-clé
Adolescent, Adult, Aged, Aged, 80 and over, Analysis of Variance, Critical Illness, Enteral Nutrition, Female, Humans, Intubation, Gastrointestinal, Logistic Models, Male, Middle Aged, Polyurethanes, Prospective Studies, Respiration, Artificial, Severity of Illness Index, Treatment Outcome
Pubmed
Web of science
Création de la notice
24/01/2008 18:03
Dernière modification de la notice
03/03/2018 16:50
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