Endoscopic nasoenteral feeding tube placement following cardiothoracic surgery.
Our purpose was to evaluate the safety and efficacy of nasoenteral feeding tube placement in the cardiothoracic surgery patients. This is a retrospective analysis of 15 critically ill cardiothoracic surgery patients who underwent endoscopic placement of an enteral feeding tube beyond the proximal duodenum for maintenance of nutrition. Twenty-five entriflex 10-F nasoenteral tubes were placed endoscopically using a modified technique far into the distal duodenum, and the placement was confirmed radiographically. Mean patient age was 71 years. Seven were males and 8 were females. Eleven had undergone coronary artery bypass surgery, two aortic valve replacement, and two aortic aneurysm repair. The mean duration of tube function was 8.5 days and mean duration of tube feeding was 15.7 days. Of the total 15 patients, 7 required replacement due to various reasons, the most common being self extubation by the patient and malpositioning after initial placement. No cardiac complications or any other complications were noted directly related to the endoscopic procedure. In eight patients, the mean serum albumin level did not change [before: 2.5mg/dL, after: 2.6mg/dL] for the short time (avg. 8.5 days) the tube was functional.


CONCLUSIONS
1) Endoscopic placement of the nasoenteral tubes is a safe method of providing enteral nutrition in critically ill cardiothoracic surgery patients. 2) Benefits of nasoenteral tubes compared to nasogastric tubes remain unproven, and frequent repositioning of nasoenteral tubes is required. 3) A prospective comparison of nasoenteral and nasogastric tubes is warranted.
Vaswani
S K
SK
Department of Internal Medicine, St. Louis University School of Medicine, Missouri, USA.
Clarkston
W K
WK
D000368:Aged; D006348:Cardiac Surgical Procedures; D016638:Critical Illness; D004724:Endoscopy; D004750:Enteral Nutrition / Q000295:instrumentation; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal; D008297:Male; D012189:Retrospective Studies; D012449:Safety; D013903:Thoracic Surgery