T. Nishimura1, H. Sakata1, T. Yamada1, A. Hashimoto1, K. Kohama1, J. Kotani1, A. Nakao1 1Hyogo College Of Medicine,Department Of Emergency And Critical Care Medicine,Mukogawacyo 1-1 ,Nishinomiya City, HYOGO PREFECTURE, Japan
Introduction:
Enteral feefing has become an important means of providing nutritional support to seriously ill patients.Placement of the feeding tube through the pyloric ring and past the ligament of Treitz into the proximal jejunum is critical to reduce the risk of gastroesophageal regurgitation and microaspiration.
Methods:
We started utilizing transnasal endoscopy for intestinal feeding tube placement, placing enteral tubes for 40 patients between March 2008 and February 2010. Although we achieved a high succes rate comparable to previous reports, we experienced several cases of failure, which was corrected with repeated endoscopy. Based on these experiences, we modified our method by adding a “double check” transnasal endoscopy through the other nasal passage.
Results:
After April 2010, we have placed the feeding tube by “double check” method for all patients (more than 40 patients) who required transnasal endoscopic feeding tube placement. We have not experienced any misplacement in all these patients after 24 h later with 100% successful rate since the introduction of “double check” procedure.
Conclusion:
We describe our experience with “double check” transnasal endoscopic feeding tube placement, which we found to be a helpful adjunct, for patients in intensive care unit.