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Randomized Controlled Trial
. 2023 May 19;102(20):e33795.
doi: 10.1097/MD.0000000000033795.

Effectiveness of techniques for insertion of nasoenteral probe in critical patients: Randomized clinical trial

Cintia Galvão Queiroz  1 , Joyce Karolayne Dos Santos Dantas  2 , Sara Cristina Matias de Araújo  2 , Mayara Araújo Rocha  1 , Francisco De Cassio de Olivira Mendes  1 , Kleyton Santos Medeiros  3 , Daniele Vieira Dantas  4 , Rodrigo Assis Neves Dantas  4
Affiliations
Randomized Controlled Trial

Effectiveness of techniques for insertion of nasoenteral probe in critical patients: Randomized clinical trial

Cintia Galvão Queiroz et al. Medicine (Baltimore). .

Abstract

Introduction: despite being a common procedure, nasally placed small-bowel feeding tube insertion is not risk-free and can compromise patient safety. Due to the fact that nasally placed small-bowel feeding tube is commonly inserted '"blindly," with the patient head in the neutral position, sometimes the process becomes difficult and traumatic, and may present higher level of complexity in physiological or induced coma and intubated patients. Therefore, adverse events (AEs) route errors can occur during this procedure. This study aimed to determine the effectiveness of different nasally placed small-bowel feeding tube insertion techniques in coma and intubated patients, in comparison with conventional method.

Methods: A prospective, randomized and controlled clinical trial will be carried out with coma and intubated patients admitted to the Intensive Care Unit (ICU). Thirty-nine patients will be randomly divided into 3 groups: group who will have the tube inserted in a conventional manner with the head in the neutral position, group with the head positioned laterally to the right, and, finally, with the head in the neutral position, with assistance of a laryngoscope. The primary endpoint will be: first, second and total attempt success rate; and time required for the first successful attempt and the sum of all attempts. Complications during insertion included tube bending, twisting, knotting, mucosal bleeding, and insertion into the trachea. Patient vital signs will be measured.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Flowchart of inclusion, allocation, follow-up procedures and study endpoints. Natal/RN, 2021. *Patients with coagulopathy (abnormal prothrombin time, partial thromboplastin time and platelet disorders); nasal stenosis; upper respiratory tract anomalies; esophageal disorders (esophageal hiatus hernia, esophageal varices, esophageal or nasopharyngeal carcinoma); skull base fracture; teeth with mobility and history of difficult intubation.
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