Bedside Postpyloric Tube Placement and Enteral Nutrition Delivery in the Pediatric Intensive Care Unit.

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Abstrakt

Tytuł:: Bedside Postpyloric Tube Placement and Enteral Nutrition Delivery in the Pediatric Intensive Care Unit.
Autorzy:: Turner AD; Department of Medicine, Boston, Massachusetts, USA.
Hamilton SM; Department of Cardiovascular/Critical Care Nursing, Boston, Massachusetts, USA.
Callif C; Department of Anesthesiology, Critical Care and Pain Medicine, Boston, Massachusetts, USA.
Ariagno KA; Center for Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA.
Arena AE; Center for Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA.
Mehta NM; Department of Anesthesiology, Critical Care and Pain Medicine, Boston, Massachusetts, USA.; Center for Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA.; Harvard Medical School, Boston, Massachusetts, USA.
Martinez EE; Department of Anesthesiology, Critical Care and Pain Medicine, Boston, Massachusetts, USA.; Harvard Medical School, Boston, Massachusetts, USA.
Źródło:: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition [Nutr Clin Pract] 2020 Apr; Vol. 35 (2), pp. 299-305. Date of Electronic Publication: 2020 Jan 28.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: 2018- : [Hoboken, NJ] : Wiley
Original Publication: [Baltimore, Md. : Williams & Wilkins, c1986-
MeSH Terms:: Intensive Care Units, Pediatric*
Point-of-Care Systems*
Enteral Nutrition/*methods
Intubation, Gastrointestinal/*methods
Adolescent ; Child ; Child, Preschool ; Critical Illness/therapy ; Energy Intake ; Enteral Nutrition/nursing ; Female ; Humans ; Infant ; Intubation, Gastrointestinal/nursing ; Male ; Parenteral Nutrition ; Respiratory Aspiration/prevention & control ; Respiratory Tract Diseases/epidemiology ; Respiratory Tract Diseases/therapy ; Retrospective Studies
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Contributed Indexing:: Keywords: critical illness; enteral nutrition; nurses; patient safety; pediatrics; tube placement
Entry Date(s):: Date Created: 20200129 Date Completed: 20201102 Latest Revision: 20201102
Update Code:: 20240105
DOI:: 10.1002/ncp.10452
PMID:: 31990093
: Czasopismo naukowe

Background: Enteral nutrition (EN) delivery may be more effective via a postpyloric (PP) feeding tube in critically ill children, but tube placement can be challenging. We aimed to describe PP tube placement and EN practices in a multidisciplinary pediatric intensive care unit (PICU) after the implementation of a nurse-led bedside PP tube-placement program.
Methods: In a single-center retrospective study, we identified 100 consecutive patients admitted to the PICU for >48 hours and for whom PP tube placement was attempted. Demographics, clinical characteristics, and details of PP tube placement and EN delivery were examined.
Results: The study cohort had a median age (25th, 75th percentiles) of 3.89 years (0.55, 14.86); 66% were male. Respiratory illness was the primary diagnosis of admission (55%); 92% were on respiratory support. Risk of aspiration was the primary indication for PP tube placement (48%). Bedside placement was the initial technique for PP tube placement in 93% of patients (successful for 84.9%) and was not associated with serious complications. Eighty-seven patients with a PP tube started EN and received a median 73.9% (12.3%, 100%) of prescribed energy goal on day 3 after EN initiation. PP EN allowed 14 of 39 patients receiving parenteral nutrition (PN) to transition off PN 7 days after EN initiation. Thirty-five percent of EN interruptions were due to feeding-tube dysfunction.
Conclusion: Bedside PP tube placement is safe and feasible and allows for effective EN delivery and decreased PN use when applicable. Interruptions in PP EN due to tube malfunction are prevalent.
(© 2020 American Society for Parenteral and Enteral Nutrition.)

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