title: A multicenter, prospective study of the placement of transpyloric feeding tubes with assistance of a magnetic device. The Magnet-Guided Enteral Feeding Tube Study Group.
abstract: BACKGROUND
  Placement of feeding tubes in the transpyloric position can be helpful in the management of enterally fed patients with pancreatitis, gastric atony, enterocutaneous fistulae, or pulmonary aspiration risk. The attainment of transpyloric position is difficult, and numerous techniques have been proposed to help in achieving this location. Recently, the use of a magnet-tipped feeding tube, dragged into proper position with an external magnet, has been described with an excellent success rate.
  
  
  METHODS
  At 10 participating institutions, practitioners were trained in the use of the device. Successful tube placement was determined by abdominal radiograph.
  
  
  RESULTS
  One hundred fifty-six tube placements were attempted. Transpyloric position was obtained in 60%. Placement into the third portion of the duodenum or distal was obtained in only 32%. Analysis of the data did not reveal a learning curve at the institutions, and 7 of 10 had a 50% or lower success rate.
  
  
  CONCLUSIONS
  Placement of feeding tubes with the assistance of a magnetic device was infrequently successful at the majority of institutions where it was attempted. We report a lower success rate than the original article, which described an 88% success rate of transpyloric intubation. Although this technique has a high failure rate, some individuals seem to be very successful using it, which could reduce the need for endoscopy or transport for the placement of feeding tubes.
authors.affiliation: Department of Medicine, University of New Mexico Health Sciences Center, Albuquerque 87131-5271, USA.
authors.forename: M
authors.initials: M
authors.lastname: Boivin
authors.forename: H
authors.initials: H
authors.lastname: Levy
authors.forename: J
authors.initials: J
authors.lastname: Hayes
mesh_terms: D055590:Electromagnetic Phenomena; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011708:Pylorus