Endoscopic findings during placement of postpyloric feeding tubes in intensive care patients: a retrospective observational study.
OBJECTIVE
To investigate the prevalence and clinical significance of upper gastrointestinal (UGI) findings during endoscopic placement of postpyloric feeding tubes in intensive care patients.


METHODS
A retrospective observational case study conducted at the intensive care unit in a single tertiary teaching hospital in New Zealand.


METHODS
Intensive care patients who underwent postpyloric feeding tube insertion under endoscopic guidance, January 2008 - August 2011.


METHODS
Endoscopic findings at tube placement and risk factors for UGI abnormalities. UGI abnormalities were considered to be clinically significant if recommendations for patient management or follow-up endoscopy were made.


RESULTS
19 patients underwent feeding tube placement during the study period and 17 endoscopy reports could be retrieved. UGI abnormalities were diagnosed in 16/17 patients: erosions from nasogastric tube (7), gastritis (4), oesophagitis (2), gastric ulcer (1) and duodenal ulcer (1). Seven patients had clinically significant endoscopic findings that prompted treatment recommendations. Risk factors for UGI abnormalities included previous UGI abnormalities in six patients and antiplatelet treatment in seven patients. In addition, our patient series was characterised by a high median Acute Physiology and Chronic Health Evaluation II score (24.5; interquartile range [IQR], 17.8-28.3) and Sequential Organ Failure Assessment score (9; IQR, 6-12).


CONCLUSIONS
Endoscopic placement of postpyloric feeding tubes resulted in the identification of a significant number of patients with previously undiagnosed UGI abnormalities.
Intensive Care Unit, Canberra Hospital, Canberra, ACT, Australia. fvanharen@me.com
Frank M P
FM
van Haren
Stephen
S
Ram
Jason
J
Hill
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care; D004724:Endoscopy; D004750:Enteral Nutrition; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D007441:Intubation, Gastrointestinal; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D015995:Prevalence; D011708:Pylorus; D012189:Retrospective Studies; D055815:Young Adult