Evidence Based Strategies for Blind Placement of Nasojejunal Feeding Tubes in ICU Patients.

Abstract

Objective: To systematically retrieve, evaluate, and summarize the best available evidence regarding the blind placement of nasojejunal feeding tubes in adult ICU patients with the goal of informing standardized clinical protocols and enhancing patient safety.

Methods: A comprehensive literature search was conducted in UpToDate, BMJ Best Practice, Cochrane Library, Joanna Briggs Institute (JBI) evidence-based healthcare database, guideline repositories, and relevant Chinese and international databases. Professional websites related to critical care and clinical nutrition were reviewed. The literature included clinical guidelines, expert consensus statements, organizational standards, clinical decision tools, evidence summaries, systematic reviews, randomized controlled trials (RCTs), and quasi-experimental studies. The search spanned from inception to August 2025. Two independent evidence-based nursing researchers appraised the quality of eligible sources and extracted evidence aligned with clinical relevance.

Results: A total of 29 studies were included, consisting of four clinical guidelines, three expert consensus statements, one organizational standard, two clinical decision tools, two evidence summaries, four systematic reviews, 10 RCTs, and three quasi-experimental studies. From these, 35 evidence statements were synthesized across 9 domains: indications, contraindications, patient assessment, catheter preparation, positioning, insertion techniques, tube placement confirmation, troubleshooting, and tube maintenance.

Conclusion: This study summarizes the highest-quality evidence to date on blind placement of nasojejunal tubes in critically ill adults. These findings may support the development of standardized protocols, optimize procedural success, and improve overall patient safety in critical care nutrition.