ABSTRACT
BACKGROUND: The preferred route for providing nutrition in the pediatric intensive care unit is enteral. Placement of postpyloric feeding tubes using an electromagnetic-tipped stylet that emits a signal detected by a device held over the patient's abdomen is effective in adult intensive care units, but has not been well studied in pediatric units. OBJECTIVES: To determine the effectiveness of the electromagnetic device in reducing the numbers of radiation exposures, intrahospital transports, tubes used, and tube placement attempts in the pediatric intensive care unit. METHODS: Data from a historical control group were compared with data from a prospective intervention group of patients less than 18 years of age and weighing at least 3 kg who required a postpyloric feeding tube in a 23-bed pediatric intensive care unit. Primary outcome was number of radiation exposures. Independent-samples Student t tests were used to compare the 2 study groups for mean equality; Pearson χ2 tests were used to compare categorical data. Statistical testing was 2-sided, and P less than .05 was considered statistically significant. RESULTS: Of 73 children (30 in control group, 43 in intervention group), those in the intervention group had a higher success rate at tube placement (P = .009) and fewer radiation exposures (P = .006), intrahospital transports (P = .004), and tubes used (P < .001). CONCLUSIONS: Successful placement of postpyloric feeding tubes by nurse practitioners was safely enhanced using an electromagnetic device. Establishing users' expertise with the device before studying outcomes may improve effectiveness.
