Enteral feeding is believed to be the preferred route of nutrition for critically ill, unconscious patients who have a functional gastrointestinal tract but are unable to swallow. Unfortunately, it is under-utilized because of the technical difficulties associated with transpyloric placement of the feeding tube. This research is intended to complete the development of a magnetically- guided enteral feeding tube for distal duodenum placement without the need for fluoroscopy, endoscopy, or medication, and to evaluate transferability of the new technique and device to other users. The feeding tube will have a small magnet and a magnetic field sensor at the distal end, electrically connected to a light indicator at the tube proximal end. A hand-held external magnet will be used to maneuver the tube distal end to the duodenum. The light indicator signals when the external magnet has adequately capture the tube distal end magnet, facilitating the placement procedure. A pilot study on 20 patients showed 95% success rate of duodenal placement at first attempt. A prospective study by 6 surgery resident and 6 ICU nurses using 200 tubes is planned to validate this technology.
This innovative technology will provide a much needed device for quick enteral access, nutritional support, and administration of medication to critically ill patients at a low cost, without need for fluoroscopy or endoscopy. Duodenal placement can be established by retrieval of bile with pH of 8 without need for x-ray. This is an advantage specially in nursing hormones where x ray is not readily available. Projected cost savings for the health care system is substantial with expected better patient outcome.
| Roberts, Susan; Echeverria, Pamela; Gabriel, Sabrey A (2007) Devices and techniques for bedside enteral feeding tube placement. Nutr Clin Pract 22:412-20 |
