A Randomized Controlled Trial Comparing Two Techniques of Enteral Feeding Tube Placement in Critically Ill Newborn Infants.

Background: Feeding intolerance can hinder enteral nutrition in infants, often necessitating transpyloric tube feeding. However, the success of transpyloric tube placement varies.

Purpose: To compare the rate of correct transpyloric tube placement in infants with and without gastric air insufflation, and to assess complications associated with postpyloric feeding.

Methods: A randomized controlled trial was conducted in a tertiary neonatal unit of a public teaching hospital. The estimated sample size included 11 participants in the intervention group (IG) and 11 in the control group (CG). In the IG, transpyloric tube insertion was aided by gastric air insufflation. Correct positioning was defined as the distal end of the tube reaching the third or fourth portion of the duodenum, as confirmed by radiography.

Results: The success rate of correct tube placement was the same in both groups (45.4% vs 45.4%, P = 1.000). Two infants experienced complications (necrotizing enterocolitis and jejunal perforation), neither of which were related to the procedure.

Implications for practice and research: There were no significant differences between the IG and CG in terms of birth weight (1030 g vs 985 g, P = .895), gestational age (27 weeks vs 28 weeks, P = .973), or age at the time of the procedure (28 days vs 39 days, P = .224). The rate of jejunal tube placement was also statistically similar (27.7% vs 9.1%, P = .269). Gastric air insufflation did not increase the rate of successful transpyloric tube placement. Observed complications were not attributable to the procedure.