The routine bridling of nasojejunal tubes is a safe and effective method of reducing dislodgement in the intensive care unit.
OBJECTIVE
To determine if the routine bridling of nasoenteric feeding tubes in the intensive care unit is a low-morbidity, cost-effective method of decreasing tube dislodgement.


METHODS
Data were prospectively collected from 62 consecutive bridled patients and compared with that from 172 consecutive unbridled patients for differences in tube dislodgement, nasal ulceration, and estimated cost.


RESULTS
Bridled patients demonstrated significantly less tube dislodgement (6.5% vs 32.6%, P < .0001). Bridling resulted in 4 cases of nasal ulceration per 800 tube feeding days, all of which were associated with red rubber catheter bridles. Conversion to 1/8-in umbilical tape bridles eliminated ulceration and further reduced dislodgement from 10% to 4.8%. Implementation of bridling saved an estimated $4038 over 3 months.


CONCLUSIONS
Nasal bridling is a simple, cost-effective practice that may reduce the rate of nasoenteric tube dislodgement. The use of 1/8-in umbilical tape may be more effective and safer than 8-Fr red rubber catheters for this purpose.
Seder
Christopher W
CW
Department of Surgery, William Beaumont Hospital, Royal Oak, MI 48073, USA. cwseder@yahoo.com
Janczyk
Randy
R
D003362:Cost-Benefit Analysis; D004750:Enteral Nutrition / Q000191:economics / Q000295:instrumentation* / Q000379:methods*; D017721:Hospital Costs; D006801:Humans; D007362:Intensive Care Units / Q000191:economics / Q000592:standards*; D007441:Intubation, Gastrointestinal / Q000191:economics / Q000295:instrumentation* / Q000379:methods*; D012307:Risk Factors; D012449:Safety