Safety analysis of delayed use of nasointestinal tube / 中国医师杂志

ABSTRACT

Objective:To investigate the indwelling time of nasointestinal tube and the safety of delayed use, and to analyze the main influencing factors.Methods:216 patients with indwelling nasointestinal tube were analyzed retrospectively by designing a survey from 2018 to 2020. Receiver operating characteristic curve (ROC) analysis method was used to analyze the threshold of pipe blocking time.Results:Among the 216 patients, the shortest indwelling time was 7 days and the longest was 120 days. The incidence rate of tube blockage, aspiration and accidental extubation was 6.02%(13/216), 2.78%(6/216) and 1.39%(3/216), respectively. Statistical analysis of 13 patients with tube occlusion showed that the incidence of tube occlusion was related to the indwelling time and the speed of pumping (χ 2=46.056, 36.564, P<0.05). In addition, the duration of nasointestinal tube use not only affected the incidence of tube occlusion, but also was related to the incidence of aspiration. With the prolongation of catheter insertion time, the rate of tube occlusion and the incidence of aspiration also increased significantly (χ 2=13.190, P<0.05). ROC curve was used to analyze the correlation between the indwelling time of the feeding tube and the occlusion. The area under the ROC curve was 0.933 (95% CI 0.886-0.981, P<0.001), the Youden index was 0.829, and the cut-off value of the best indwelling time was 52.5 d. The sensitivity and specificity of the method for determining the occurrence of pipe blockage were 92.3% and 90.6%. Conclusions:It is safe and feasible to extend the indwelling time of nasointestinal tube appropriately, which can reduce the discomfort caused by frequent replacement of nasointestinal tube in patients with long-term enteral nutrition, and reduce the medical cost at the same time. However, when the indwelling time exceeds the threshold, the probability of tube blockage increases significantly, so we should maintain the catheter or replace it in time.