Chest
Clinical Investigations in Critical CareBedside Method for Placing Small Bowel Feeding Tubes in Critically III Patients: A Prospective Study
Section snippets
Patients
We established a “feeding tube placement” service in our intensive care unit (ICU) in 1987. We report herein the results of 231 consecutive requests for bedside placement of a duodenal feeding tube between November 1987 and October 1990. These requests included patients admitted to the trauma (30 percent), general surgery (15 percent), cardiac surgery (15 percent), neurosurgery (20 percent), and internal medicine (20 percent) services. The majority of patients (95 percent) were intubated at the
RESULTS
We attempted 231 bedside small bowel feeding tube placements and were successful in 213 (92 percent). Seven (3 percent) were placed into the first portion of the duodenum, 57 (25 percent) into the second portion of the duodenum, 109 (47 percent) into the third portion of the duodenum, and 40 (17 percent) into the proximal jejunum (Table 1). The average time to place the feeding tubes was 40 ±14 min (mean ± SD). We failed to enter the small bowel in 18 attempts (8 percent). These tubes were
DISCUSSION
We describe a method for placing feeding tubes into the small bowel at the bedside. A similar technique was first described by Thurlow6 in patients in the surgery ward. This technique is simple but requires some training and experience. Once mastered, however, it is highly effective (92 percent). We have taught this technique to our house officers. Most are achieving placement of 70 to 80 percent.
This bedside technique is very safe. We have monitored oxygenation using pulse oximeters in most
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Manuscript received February 19; revision accepted June 18.