Objective:To investigate the effective nursing measures of early application of nasoenteric tube for enteral nutrition in critically ill patients in ICU,and to summarize the nursing experience.Methods:The study was ca...Objective:To investigate the effective nursing measures of early application of nasoenteric tube for enteral nutrition in critically ill patients in ICU,and to summarize the nursing experience.Methods:The study was carried out in June 2023–November 2023.62 samples of ICU critically ill patients were selected,all of whom used enteral nutrition by mesenteric tube and were grouped into an observation group(n=31)and a control group(n=31)by using the numerical table randomization method.The patients in the control group were basic nursing interventions,and the patients in the observation group were comprehensive quality care,comparing the nutritional indexes,complication rates,and nursing satisfaction between the two groups.Results:All nutritional indicators of the observation group were higher than those of the control group after nursing intervention(P<0.05);the complication rate of the observation group was lower than that of the control group(P<0.05);the nursing satisfaction of the observation group was higher than that of the control group(P<0.05).Conclusion:Comprehensive quality nursing care during the early application of a gastroenteric tube for enteral nutrition in critically ill patients in the ICU can improve nutritional indexes,reduce the incidence of complications and improve nursing satisfaction.展开更多
AIM: To report the clinical experiences in the application of clip-assisted endoscopic method for nasoenteric feeding in patients with gastroparesis and patients with gastroesophageal wounds, and to compare the effica...AIM: To report the clinical experiences in the application of clip-assisted endoscopic method for nasoenteric feeding in patients with gastroparesis and patients with gastroesophageal wounds, and to compare the efficacy of nasoenteric feeding in these two indications. METHODS: From April 2002 to January 2004,21 consecutive patients with gastroparesis or gastroesophageal wounds were enrolled and received nasoenteric feeding for nutritional support. A clip-assisted method was used to place the nasoenteric tubes. Outcomes in the two groups were compared with respect to the successful rate of enteral feeding, percentage of recommended energy intake (REI), and complication rates. RESULTS: The gastroparesis group included 13 patients with major burns (n = 7), trauma (n = 2), congestive heart failure (n = 2) and post-surgery gastric stasis syndrome (n = 2). The esophageogastric wound group included eight patients with tracheoesophageal fistula (n = 2) and wound leakage following gastric surgery (n = 6). Two study groups were similar in feeding successful rates (84.6% vs 75.0%). There were also no differences in the percentage of REI between groups (79.4% vs 78.6%). Additionally, no complications occurred in any of the study groups. CONCLUSION: Nasoenteric feeding is a useful method to provide nutritional support to most of the patients with gastroparesis who cannot tolerate nasogastric tube feeding and to the cases who need bypass feeding for esophageogastric wounds.展开更多
Gastroenteric tube feeding plays a major role in the management of patients with poor voluntary intake,chronic neurological or mechanical dysphagia or gut dysfunction,and patients who are critically ill.However,despit...Gastroenteric tube feeding plays a major role in the management of patients with poor voluntary intake,chronic neurological or mechanical dysphagia or gut dysfunction,and patients who are critically ill.However,despite the benefits and widespread use of enteral tube feeding,some patients experience complications.This review aims to discuss and compare current knowledge regarding the clinical application of enteral tube feeding,together with associated complications and special aspects.We conducted an extensive literature search on PubMed,Embase and Medline using index terms relating to enteral access,enteral feeding/nutrition,tube feeding,percutaneous endoscopic gastrostomy/jejunostomy,endoscopic nasoenteric tube,nasogastric tube,and refeeding syndrome.The literature showed common routes of enteral access to include nasoenteral tube,gastrostomy and jejunostomy,while complications fall into four major categories:mechanical,e.g.,tube blockage or removal;gastrointestinal,e.g.,diarrhea;infectious e.g.,aspiration pneumonia,tube site infection;and metabolic,e.g.,refeeding syndrome,hyperglycemia.Although the type and frequency of complications arising from tube feeding vary considerably according to the chosen access route,gastrointestinal complications are without doubt the most common.Complications associated with enteral tube feeding can be reduced by careful observance of guidelines,including those related to food composition,administration rate,portion size,food temperature and patient supervision.展开更多
Postpyloric feeding is an important and promising alternative to parenteral nutrition. The indications for this kind of feeding are increasing and include a variety of clinical conditions, such as gastroparesis, acute...Postpyloric feeding is an important and promising alternative to parenteral nutrition. The indications for this kind of feeding are increasing and include a variety of clinical conditions, such as gastroparesis, acute pancreatitis, gastric outlet stenosis, hyperemesis (including gravida), recurrent aspiration, tracheoesophageal fistula and stenosis in gastroenterostomy. This review discusses the differences between pre- and postpyloric feeding, indications and contraindications, advantages and disadvantages, and provides an overview of the techniques of placement of various postpyloric devices.展开更多
BACKGROUND The jejunal nutrition tube has increasingly been used in clinical practice,and the results in frequent complications.CASE SUMMARY We present the case of a 74-year-old male patient who had been admitted to t...BACKGROUND The jejunal nutrition tube has increasingly been used in clinical practice,and the results in frequent complications.CASE SUMMARY We present the case of a 74-year-old male patient who had been admitted to the intensive care unit for aspiration pneumonia and respiratory failure.When confirming the position of the jejunal tube by X-ray,we found that the feeding tube had been placed into the chest.The complications was a disaster,though the misplacement of jejunal feeding tube are uncommon.CONCLUSION We introduced a way of ultrasound-guided jejunum feeding tube placement to avert the disaster,which was convenient and economical.展开更多
Background The placement of an enteral feeding tube is the foundation for providing enteral nutrition. But due to the anatomic complexity of the stomach and the duodenum, to a certain degree, there are some technical ...Background The placement of an enteral feeding tube is the foundation for providing enteral nutrition. But due to the anatomic complexity of the stomach and the duodenum, to a certain degree, there are some technical difficulties in the placement of postpyloric feeding tube, especially in critically ill patients. This study aimed to evaluate the efficacy and safety of placing nasoenteral feeding tube with a transnasal ultrathin endoscope. Methods Totally 49 patients, involving 46 （93.9%） being American Society of Anesthesiologists Physical Status （ASA-PS） grade III （n=3） and grade IV （n=-43）, in whom a nasoenteral feeding tube was placed with a transnasal ultrathin endoscope by using over-the-wire technique. The related clinic information during the procedure including success rate, time required, complications and monitoring results of vital signs was analyzed. Results The tube was placed at or beyond the Treitz＇s ligament in all of the 49 cases and the total tube-placement success rate was 100% including the one-time tube-placement success rate 95.9%. The tube placement was successful in 46 （93.9%） cases by transnasal method and 3 （6.1%） cases by transoral method. In the 47 cases whose one-time tube-placement success was obtained, the average procedure time was （6.2±5.6） minutes. For the 3 patients the endoscope inserted transorally due to the failure of transnasal insertion, the total procedure time was （12.3±2.1） minutes. In the period of nasoenteral tube placement, the average systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate （HR） and average pulse oxygen saturation （SpO2） did not show any significant change. Apart from 3 patients in whom nausea occurred in the procedure and 2 nasal bleeding, no any other acute complications arose. Conclusion The method of placing nasoenteral feeding tube with the transnasal ultrathin endoscope is not only efficient, time-saving, technically simple, and painless to patients, but also safe especially in critically ill patients.展开更多
文摘Objective:To investigate the effective nursing measures of early application of nasoenteric tube for enteral nutrition in critically ill patients in ICU,and to summarize the nursing experience.Methods:The study was carried out in June 2023–November 2023.62 samples of ICU critically ill patients were selected,all of whom used enteral nutrition by mesenteric tube and were grouped into an observation group(n=31)and a control group(n=31)by using the numerical table randomization method.The patients in the control group were basic nursing interventions,and the patients in the observation group were comprehensive quality care,comparing the nutritional indexes,complication rates,and nursing satisfaction between the two groups.Results:All nutritional indicators of the observation group were higher than those of the control group after nursing intervention(P<0.05);the complication rate of the observation group was lower than that of the control group(P<0.05);the nursing satisfaction of the observation group was higher than that of the control group(P<0.05).Conclusion:Comprehensive quality nursing care during the early application of a gastroenteric tube for enteral nutrition in critically ill patients in the ICU can improve nutritional indexes,reduce the incidence of complications and improve nursing satisfaction.
基金Supported by the Grants from the Kaohsiung Veterans General Hospital (VGHSU-93-26)
文摘AIM: To report the clinical experiences in the application of clip-assisted endoscopic method for nasoenteric feeding in patients with gastroparesis and patients with gastroesophageal wounds, and to compare the efficacy of nasoenteric feeding in these two indications. METHODS: From April 2002 to January 2004,21 consecutive patients with gastroparesis or gastroesophageal wounds were enrolled and received nasoenteric feeding for nutritional support. A clip-assisted method was used to place the nasoenteric tubes. Outcomes in the two groups were compared with respect to the successful rate of enteral feeding, percentage of recommended energy intake (REI), and complication rates. RESULTS: The gastroparesis group included 13 patients with major burns (n = 7), trauma (n = 2), congestive heart failure (n = 2) and post-surgery gastric stasis syndrome (n = 2). The esophageogastric wound group included eight patients with tracheoesophageal fistula (n = 2) and wound leakage following gastric surgery (n = 6). Two study groups were similar in feeding successful rates (84.6% vs 75.0%). There were also no differences in the percentage of REI between groups (79.4% vs 78.6%). Additionally, no complications occurred in any of the study groups. CONCLUSION: Nasoenteric feeding is a useful method to provide nutritional support to most of the patients with gastroparesis who cannot tolerate nasogastric tube feeding and to the cases who need bypass feeding for esophageogastric wounds.
文摘Gastroenteric tube feeding plays a major role in the management of patients with poor voluntary intake,chronic neurological or mechanical dysphagia or gut dysfunction,and patients who are critically ill.However,despite the benefits and widespread use of enteral tube feeding,some patients experience complications.This review aims to discuss and compare current knowledge regarding the clinical application of enteral tube feeding,together with associated complications and special aspects.We conducted an extensive literature search on PubMed,Embase and Medline using index terms relating to enteral access,enteral feeding/nutrition,tube feeding,percutaneous endoscopic gastrostomy/jejunostomy,endoscopic nasoenteric tube,nasogastric tube,and refeeding syndrome.The literature showed common routes of enteral access to include nasoenteral tube,gastrostomy and jejunostomy,while complications fall into four major categories:mechanical,e.g.,tube blockage or removal;gastrointestinal,e.g.,diarrhea;infectious e.g.,aspiration pneumonia,tube site infection;and metabolic,e.g.,refeeding syndrome,hyperglycemia.Although the type and frequency of complications arising from tube feeding vary considerably according to the chosen access route,gastrointestinal complications are without doubt the most common.Complications associated with enteral tube feeding can be reduced by careful observance of guidelines,including those related to food composition,administration rate,portion size,food temperature and patient supervision.
文摘Postpyloric feeding is an important and promising alternative to parenteral nutrition. The indications for this kind of feeding are increasing and include a variety of clinical conditions, such as gastroparesis, acute pancreatitis, gastric outlet stenosis, hyperemesis (including gravida), recurrent aspiration, tracheoesophageal fistula and stenosis in gastroenterostomy. This review discusses the differences between pre- and postpyloric feeding, indications and contraindications, advantages and disadvantages, and provides an overview of the techniques of placement of various postpyloric devices.
基金Supported by The Science and Technology Project of Taizhou,No.1902KY02.
文摘BACKGROUND The jejunal nutrition tube has increasingly been used in clinical practice,and the results in frequent complications.CASE SUMMARY We present the case of a 74-year-old male patient who had been admitted to the intensive care unit for aspiration pneumonia and respiratory failure.When confirming the position of the jejunal tube by X-ray,we found that the feeding tube had been placed into the chest.The complications was a disaster,though the misplacement of jejunal feeding tube are uncommon.CONCLUSION We introduced a way of ultrasound-guided jejunum feeding tube placement to avert the disaster,which was convenient and economical.
文摘Background The placement of an enteral feeding tube is the foundation for providing enteral nutrition. But due to the anatomic complexity of the stomach and the duodenum, to a certain degree, there are some technical difficulties in the placement of postpyloric feeding tube, especially in critically ill patients. This study aimed to evaluate the efficacy and safety of placing nasoenteral feeding tube with a transnasal ultrathin endoscope. Methods Totally 49 patients, involving 46 （93.9%） being American Society of Anesthesiologists Physical Status （ASA-PS） grade III （n=3） and grade IV （n=-43）, in whom a nasoenteral feeding tube was placed with a transnasal ultrathin endoscope by using over-the-wire technique. The related clinic information during the procedure including success rate, time required, complications and monitoring results of vital signs was analyzed. Results The tube was placed at or beyond the Treitz＇s ligament in all of the 49 cases and the total tube-placement success rate was 100% including the one-time tube-placement success rate 95.9%. The tube placement was successful in 46 （93.9%） cases by transnasal method and 3 （6.1%） cases by transoral method. In the 47 cases whose one-time tube-placement success was obtained, the average procedure time was （6.2±5.6） minutes. For the 3 patients the endoscope inserted transorally due to the failure of transnasal insertion, the total procedure time was （12.3±2.1） minutes. In the period of nasoenteral tube placement, the average systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate （HR） and average pulse oxygen saturation （SpO2） did not show any significant change. Apart from 3 patients in whom nausea occurred in the procedure and 2 nasal bleeding, no any other acute complications arose. Conclusion The method of placing nasoenteral feeding tube with the transnasal ultrathin endoscope is not only efficient, time-saving, technically simple, and painless to patients, but also safe especially in critically ill patients.
