Electromagnetic-guided placement of nasoduodenal feeding tubes versus endoscopic placement: a randomized, multicenter trial
| العنوان: | Electromagnetic-guided placement of nasoduodenal feeding tubes versus endoscopic placement: a randomized, multicenter trial |
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| المؤلفون: | Ingeborg van der Tweel, Paul H. Stadhouders, Hendrik J.A. Jebbink, Frank J. Wessels, Jan Willem Kappelle, Wouter F.W. Kappelle, Medard F.M. Van den Broek, Daisy Walter, Peter J. van der Schaar, Jan F. Monkelbaan, Frank P. Vleggaar, Peter D. Siersema |
| المصدر: | Gastrointestinal Endoscopy, 87, 1, pp. 110-118 Gastrointestinal Endoscopy, 87(1), 110. Mosby Inc. Gastrointestinal Endoscopy, 87, 110-118 |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Adult, Male, Radiography, Abdominal, Abdominal pain, medicine.medical_specialty, Gastroparesis, Vomiting, Critical Illness, medicine.medical_treatment, Conscious Sedation, law.invention, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 03 medical and health sciences, Enteral Nutrition, All institutes and research themes of the Radboud University Medical Center, 0302 clinical medicine, Randomized controlled trial, law, Multicenter trial, Clinical endpoint, Journal Article, Humans, Medicine, Intubation, Radiology, Nuclear Medicine and imaging, Endoscopy, Digestive System, 030212 general & internal medicine, Intubation, Gastrointestinal, Aged, Intention-to-treat analysis, business.industry, Gastroenterology, Middle Aged, Intensive care unit, Intention to Treat Analysis, Surgery, Clinical trial, Intensive Care Units, Pancreatitis, Radiology Nuclear Medicine and imaging, Magnets, Female, 030211 gastroenterology & hepatology, medicine.symptom, business |
| الوصف: | Background and Aims Electromagnetic-guided placement (EMP) of a nasoduodenal feeding tube by trained nurses is an attractive alternative to EGD-guided placement (EGDP). We aimed to compare EMP and EGDP in outpatients, ward patients, and critically ill patients with normal upper GI anatomy. Methods In 3 centers with no prior experience in EMP, patients were randomized to placement of a single-lumen nasoduodenal feeding tube either with EGDP or EMP. The primary endpoint was post-pyloric position of the tube on abdominal radiography. Patients were followed for 10 days to assess patency and adverse events. The analyses were performed according to the intention-to-treat principle. Results In total, 160 patients were randomized to EGDP (N = 76) or EMP (N = 84). Three patients withdrew informed consent, and no abdominal radiography was performed in 2 patients. Thus, 155 patients (59 intensive care unit, 38%) were included in the analyses. Rates of post-pyloric tube position between EGDP and EMP were comparable (79% vs 82%, odds ratio 1.16; 90% confidence interval, 0.58-2.38; P = .72). Adverse events were observed in 4 patients after EMP (hypoxia, GI blood loss, atrial fibrillation, abdominal pain) and in 4 after EGDP (epistaxis N = 2, GI blood loss, hypoxia). Costs of tube placements were lower for EMP compared with EGDP: $519.09 versus $622.49, respectively ( P = .04). Conclusions Success rates and safety of EMP and EGDP in patients with normal upper GI anatomy were comparable. Lower costs and potential logistic advantages may drive centers to adopt EMP as their new standard of care. (Clinical trial registration number: NTR4286.) |
| وصف الملف: | image/pdf |
| تدمد: | 0016-5107 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ec87127825da26a9d789570af5e71bdf https://doi.org/10.1016/j.gie.2017.05.033 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....ec87127825da26a9d789570af5e71bdf |
| قاعدة البيانات: | OpenAIRE |
Full Text via ClinicalKey | تدمد: | 00165107 |
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