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Objective To evaluate the effect of blind bedside non-spiral nasointestinal tubes in critically ill patients.Methods Patients requiring bedside nasointenstinal tubes in intensive care unit of Nanjing First Hospital from February 2017 to February 2018 were enrolled in this study.The placement of nasointenstinal tubes was conducted according to the reference procedure of our department,recording operation times,operation duration,position of the tube's tip,expense and complications.Results A total of 53 patients received the bedside non-spiral nasointenstinal tubes which were conducted for 64 times.51 patients (51/53,94.4％) were successful in tube placement,45 case-times (45/64,70.3％) were successful at the first attempt,and 50 case-times (50/64,78.1％) were successful at the second attempt in accumulation.The mean time of our procedure was (13.80±6.90) minutes,the mean insertion length was (99.55±8.35) cm,and the mean expense was (244.82±45.68) Yuan.No severe complications were observed.Conclusion Blind bedside placement of non-spiral nasointestinal tubes has high success rate and many advantages as short operation time,low expense and less complications,which is a good choice for early establishment of enteral feeding pathway and early supplement of enteral nutrition in critically ill patients.
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Objective To evaluate the effect of indwelling nasointestinal tube for enteral nutrition (EN) support on patients with severe craniocerebral trauma undergoing mechanical ventilation (MV). Methods A total of 100 severe craniocerebral trauma patients undergoing MV admitted to intensive care unit (ICU) of the 117th Hospital of People's Liberation Army from February 2015 to February 2017 were enrolled, and they were divided into nasogastric tube group in which the EN was fed by nasogastric tube and nasal jejunal feeding tube group (nasointestinal tube group) by random digits table, with 50 patients in each group. Blood urea nitrogen (BUN), hemoglobin (Hb), serum albumin (Alb), acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score, Glasgow coma scale (GCS) score before and 10 days after treatment, duration of MV, hospitalization time, and the incidences of ventilator-associated pneumonia (VAP) and reflux wrong aspiration of the two groups were observed and compared. Results There was no statistically significant difference in BUN, Hb, Alb, APACHEⅡscore or GCS score before treatment between the two groups. Ten days after treatment, BUN and APACHEⅡ score in the nasointestinal tube group were significantly lower than those in the nasogastric tube group [BUN (mmol/L): 6.3±1.6 vs. 8.0±2.2, APACHEⅡscore: 17.9±3.2 vs. 20.8±6.3, both P < 0.05], Hb, Alb, GCS score were significantly higher than those in nasogastric tube group [Hb (g/L): 125.9±19.7 vs. 113.5±19.6, Alb (g/L): 35.9±6.2 vs. 31.9±6.2, GCS score: 9.7±1.9 vs. 8.2±5.7, all P < 0.05], duration of MV and hospitalization time were significantly less than those in the nasogastric tube group [duration of MV (days):14.7±3.4 vs. 17.5±2.9, hospitalization time (days): 15.4±5.6 vs. 19.2±7.3, both P < 0.05], and the complication rate in nasointestinal tube group was obviously lower than that in nasogastric tube group [10% (5/50) vs. 36% (18/50), P < 0.05]. Conclusion For patients with severe craniocerebral trauma treated with MV, the EN treatment by means of indwelling nasointestinal tube is helpful for the recovery of consciousness, improvement of nutritional indexes, reduction of incidences of complications such as reflux aspiration, etc. and shortening the course of disease, thus the method can obviously improve the patients quality of life.
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Objective To assess the value of bedside gastrointestinal ultrasound combined with gaswater alternate injection on nasointestinal tube positioning in critically ill patients.Methods A total of 62 critically ill patients requiring post-pyloric enteral nutrition admitted to the intensive care unit in our Hospital from May 1,2017 to December 1,2017 were enrolled.Nasointestinal tubes were blindly inserted in a bedside setting.Then,we evaluated the nasointestinal tube position using both an ultrasound with gas-water alternate injection and the traditional auscultation method after gas perfusion.Abdominal X-ray imaging was also performed in all cases as the gold standard,and the sensitivities,specificities,positive predictive values,negative predictive values,and accuracies of the tested methods were obtained.Results Sixty-two patients were confirmed by X-ray,wherein 55 were successfully catheterized and 7 were ectopic.The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of ultrasound-assisted gas-water injection were 90.9％,100％,100％,58.3％,and 91.9％,respectively,which were all higher than those of traditional gas perfusion auscultation (P ＜ 0.05).Conclusion The bedside gastrointestinal ultrasound with gas-water alternate injections for nasointestinal tube positioning in critically ill patients has a certain clinical value.
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Objective To discuss the method of stomach tube instead of normal nasointestinal tube for severe craniocerebral injury patients.Methods Placing the stomach tube into the jejunum blindly according to the patient's gastrointestinal peristalsis for 99 severe craniocerebral injury patients and observing the success rate and plugging rate.Results Ninety-two tubes were successfully placed,the success rate was 92.9％(92/99).The placement time was (45.9±26.7) min.The time of successful insertion tube enteral nutrition was (46.0±34.2) d.No clogging occurred during this period.Conclusions The method of stomach tube instead of normal nasointestinal tube is safe and effective.
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Objective To compare the effects of nasogastric tube and spiral nasointestinal tube on patients with severe brain injury. Methods Pa?tients receiving enteral nutrition with spiral nasointestinal tube or nasogastric tube were collected and investigated to evaluate the two schemes of en?teral nutrition from aspects of coma score,nutrition improvement,and catheter complications and so on. Results Detection of levels of total protein and prealbumin were conducted for all patients at 7 and 15 days after intubation. Each index was higher in the spiral nasointestinal tube group than in the nasogastric tube group. The reflux and aspiration rate was lower in the spiral nasointestinal tube group than in the nasogastric tube group. The dif?ferences were significant(P<0.05). Conclusion Using spiral nasointestinal tube to give enteral nutrition in patients with severe brain injury can improve the nutritional status,reduce complications,which is more contributory to the recovery.
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Severe acute biliary pancreatitis can be treated by nonsurgical and surgical approaches,and choice of the surgical techniques as well as its timing are the keys points to the whole therapy.Early enteral nutrition via placing nasointestinal feeding tube plays an important role in the nutritional support for patients with severe acute pancreatitis.This paper intends to explore the experience in standardizing the therapy for all similar cases via reviewing and summarizing the treating process of a typical patient with severe acute biliary pancreatitis.
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Objective To evaluate the effect of nasointestinal tube in patients receiving mechanical ventilation.Methods Patients receiving mechanical ventilation were randomLy divided into two groups.The two groups were isocaloric and isonitrogen.The study group used nasointestinal tube feeding.The control group used nasogastric tube feeding.Nutrition status,ventilator days,aspiration incidence and pneumonia incidence were measured.Results 178 patients receiving me- chanical ventilation were divided into two groups.The study group showed reduction in aspiration incidence and pneumoni- a incidence.Other measurements showed no significant difference.Conclusion Nasointestinal tube feeding could reduce aspiration and pneumonia incidence in patients receiving mechanical ventilation.