Electromagnetic-Guided Nasogastric Tube Insertion by Nurses: A Multicenter Non-Inferiority Study.

IF 2.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Annals of Nutrition and Metabolism Pub Date : 2026-01-01 Epub Date: 2026-05-21 DOI:10.1159/000552563

Hideaki Sakuramoto, Kensuke Nakamura, Megumi Kamogawa, Hideaki Note, Kazunao Mori, Junko Tatsuno, Daisuke Yamaguchi, Toshifumi Miki, Tomoaki Ikezawa, Hideki Hashimoto, Saiko Okamoto, Hitoshi Tsugu, Masako Shirasaka, Kenichi Sai, Shinya Sakamoto, Tomomi Yoshida, Saori Kajiwara

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引用次数: 0

Abstract

Introduction: Nasogastric tube feeding is essential for critically ill patients, yet blind insertion risks misplacement and related complications. Electromagnetic guidance enables real-time tracking, potentially enhancing safety and efficiency. This study aimed to compare the safety and effectiveness of nurse-led electromagnetic-guided nasogastric tube insertion with those of physician-performed blind insertion in critically ill patients.

Methods: This multicenter prospective non-inferiority trial was conducted in seven Japanese intensive care units (July 2023-February 2025). Physicians performed blind insertions in the initial phase, followed by nurse training and electromagnetic-guided insertions using the CORTRAK system. The primary outcome was successful gastric placement without special techniques. Secondary outcomes included insertion time, attempts, complications, and tube position.

Results: A total of 283 patients were analyzed (141 electromagnetic-guided, 142 blind). Success rates were similar (63.1% vs. 65.5%; difference -2.4%, 95% confidence interval: -13.5 to 8.8), confirming non-inferiority (Farrington-Manning p = 0.001). Electromagnetic-guided insertions required fewer reinsertions (median 0 vs. 1; p = 0.049) and less time (3.3 vs. 4.5 min; p = 0.03) in unadjusted analyses. No tracheobronchial misplacements occurred (blind: 1.4%). Complication rates were low and comparable.

Conclusion: Nurse-led electromagnetic-guided nasogastric tube insertion appears to be a safe, effective alternative to physician blind insertion, with comparable success and potential efficiency advantages.

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护士电磁引导鼻胃管置入：一项多中心非劣效性研究。

背景：鼻胃管喂养对危重患者至关重要，但盲目插入有放置错位和相关并发症的风险。电磁制导可以实现实时跟踪，潜在地提高安全性和效率。本研究旨在比较护士引导的电磁引导鼻胃管插入与医师盲管插入在危重病人中的安全性和有效性。方法：这项多中心前瞻性非劣效性试验于2023年7月至2025年2月在7个日本icu中进行。医生在初始阶段进行盲插入，随后进行护士培训，并使用CORTRAK系统进行电磁引导插入。主要结果是成功的胃放置，没有特殊的技术。次要结局包括置管时间、尝试次数、并发症和置管位置。结果：共分析283例患者，其中电磁引导141例，盲法142例。成功率相似（63.1% vs 65.5%；差异-2.4%,95% CI -13.5 ~ 8.8），证实非劣效性（Farrington-Manning P=0.001）。在未调整分析中，电磁引导插入需要更少的重新插入（中位数0 vs 1， P=0.049）和更少的时间（3.3 vs 4.5 min， P=0.03）。无气管支气管错位发生（盲：1.4%）。并发症发生率低且具有可比性。结论：护士引导下的电磁引导鼻胃管插入是一种安全、有效的替代医生盲插入的方法，具有相当的成功率和潜在的效率优势。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Nutrition and Metabolism 医学-内分泌学与代谢

CiteScore

6.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Annals of Nutrition and Metabolism'' is a leading international peer-reviewed journal for sharing information on human nutrition, metabolism and related fields, covering the broad and multidisciplinary nature of science in nutrition and metabolism. As the official journal of both the International Union of Nutritional Sciences (IUNS) and the Federation of European Nutrition Societies (FENS), the journal has a high visibility among both researchers and users of research outputs, including policy makers, across Europe and around the world.