鼻肠管置入:提高成功率的技术。

IF 2.1 Q3 CRITICAL CARE MEDICINE

Journal of the Intensive Care Society Pub Date : 2023-02-01 DOI:10.1177/17511437221095336

Stephen J Taylor, Kaylee Sayer, Paul White

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引用次数: 3

摘要

背景:胃排空延迟(DGE)是营养不良的主要原因，可以通过鼻肠(NI)喂养来克服，但放置胃管经常失败。我们分析了哪些技术能够成功地放置NI管。方法:在鼻、鼻咽-食道、胃-上-下、十二指肠-1部和肠6个解剖点分别测定插管技术的疗效。结果:在913例首次放置NI管的患者中，在咽部(头部倾斜、颌突、喉镜检查)、胃上部(充气，10 cm或20-30 cm柔性管尖±反向Seldinger手法)、胃下部(充气，可能有柔性管尖和金属丝加强器)和十二指肠1部分及2部分以上(柔性管尖和微推进、松弛去除、金属丝加强器或促动力药物的组合)中发现了与管推进有显著关联的情况。结论:这是第一次研究显示哪些技术与管推进和消化道水平相关。

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Nasointestinal tube placement: Techniques that increase success.

Background: Delayed gastric emptying (DGE) is a major cause of undernutrition that can be overcome using nasointestinal (NI) feeding, but tube placement often fails. We analyse which techniques enable successful NI tube placement.

Methods: Efficacy of tube technique was determined at each of six anatomical points: Nose, nasopharynx-oesophagus, stomach-upper and -lower, duodenum part-1 and intestine.

Results: In 913 first NI tube placements, significant associations with tube advancement were found in the pharynx (head tilt, jaw thrust, laryngoscopy), stomach_upper (air insufflation, 10 cm or 20-30 cm flexible tube tip ± reverse Seldinger manoeuvre), stomach_lower (air insufflation, possibly flexible tip and wire stiffener) and duodenum part-1 and beyond part-2 (flexible tip and combinations of micro-advance, slack removal, wire stiffener or prokinetic drugs).

Conclusion: This is the first study to show what techniques are associated with tube advancement and the alimentary tract level they are specific to.

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来源期刊

Journal of the Intensive Care Society Nursing-Critical Care Nursing

CiteScore

4.40

自引率

0.00%

发文量

期刊介绍： The Journal of the Intensive Care Society (JICS) is an international, peer-reviewed journal that strives to disseminate clinically and scientifically relevant peer-reviewed research, evaluation, experience and opinion to all staff working in the field of intensive care medicine. Our aim is to inform clinicians on the provision of best practice and provide direction for innovative scientific research in what is one of the broadest and most multi-disciplinary healthcare specialties. While original articles and systematic reviews lie at the heart of the Journal, we also value and recognise the need for opinion articles, case reports and correspondence to guide clinically and scientifically important areas in which conclusive evidence is lacking. The style of the Journal is based on its founding mission statement to ‘instruct, inform and entertain by encompassing the best aspects of both tabloid and broadsheet''.