title: Blind transpyloric nasojejunal versus nasogastric tube intubation in severe head injuries: a preliminary report.
abstract: OBJECTIVE
  To compare the efficacy of blind transpyloric placement using a specifically designed nasojejunal tube (NJT) versus a standard nasogastric tube (NGT) in severe head injury (SHI).
  
  
  METHODS
  This was a randomised trial conducted in a neurosurgical intensive care unit. Fourteen patients were enrolled with a Glasgow Coma Score (GCS) less than 8 (mean 6.8 SEM+/-0.36). Patients were randomised to receive either NJT or NGT.
  
  
  RESULTS
  There was an 83% (5/6 patients) spontaneous jejunal placement rate of NJT past the ligament of Treitz. The 17% (1/6 patients) jejunal placement failure rate for NJT was due to inappropriate technique. A 100% (8/8 patients) failure of the unweighted NGTs to pass through the pylorus into the jejunum was recorded (P=0.002).
  
  
  CONCLUSIONS
  In SHI, the specifically designed self-propelling NJT was effective in spontaneous transpyloric placement past the ligament of Treitz within 12h of introduction into the gastric cavity. The standard un-weighted NGT was ineffective. Additional studies are warranted to determine the clinical efficacy of this self-propelling NJT.
authors.affiliation: Department of Dietetics, Wentworth Hospital, Nelson R Mandela School of Mdicine, University of Natal, Durban, South Africa.
authors.forename: L V
authors.initials: LV
authors.lastname: Marino
authors.forename: Praneel
authors.initials: P
authors.lastname: Ramchandra
authors.forename: Narendra
authors.initials: N
authors.lastname: Nathoo
mesh_terms: D000293:Adolescent; D000328:Adult; D006259:Craniocerebral Trauma / Q000628:therapy*; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007440:Intubation; D007441:Intubation, Gastrointestinal / Q000295:instrumentation / Q000379:methods*; D007583:Jejunum / Q000601:surgery; D008297:Male; D016896:Treatment Outcome