title: Nasal bridles for securing nasoenteric tubes: a meta-analysis.
abstract: BACKGROUND
  Nasoenteric feeding tubes may easily become dislodged due to patient mental status, transfers, or positional changes. Nasal bridles were introduced to provide a better, more reliable system to secure these tubes. This meta-analysis was performed to evaluate the effectiveness of nasal bridles compared with the traditional method of adhesive tape alone in securing enteral feeding tubes.
  
  
  METHODS
  Multiple databases were searched (October 2013). All studies that evaluated the use of nasal bridles in adult patients were included in the analysis. Meta-analysis for the outcomes from use of a nasal bridle vs the more traditional method of adhesive tape alone for securing nasoenteric tubes was analyzed by calculating pooled estimates of dislodgement, skin complications, and sinusitis. Statistical analysis was performed using RevMan 5.1.
  
  
  RESULTS
  Six studies (n = 594) met the inclusion criteria. Use of a nasal bridle for securing enteral tubes resulted in a statistically significant reduction in tube dislodgement compared with traditional adhesive tape alone (odds ratio [OR], 0.16; 95% confidence interval [CI], 0.10–0.27; P < .01). The use of nasal bridles was associated with a higher rate of skin complications compared with traditional adhesive tape (OR, 4.27; 95% CI, 1.79–10.23; P < .01). Incidence of sinusitis was no different between the 2 groups (OR, 0.26; 95% CI, 0.03–2.28; P = .22).
  
  
  CONCLUSIONS
  Nasal bridles appear to be more effective at securing nasoenteric tubes and preventing dislodgement than traditional use of tape alone.
authors.affiliation: Division of Gastroenterology & Hepatology, University of Missouri Health Sciences Center, CE405, DC 043.00, Five Hospital Dr, Columbia, MO 65212, USA. Email: bechtoldm@health.missouri.edu
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Bechtold
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Nguyen
authors.forename: Lena B
authors.initials: LB
authors.lastname: Palmer
authors.forename: Laszlo N
authors.initials: LN
authors.lastname: Kiraly
authors.forename: Robert G
authors.initials: RG
authors.lastname: Martindale
authors.forename: Stephen A
authors.initials: SA
authors.lastname: McClave
mesh_terms: D004750:Enteral Nutrition / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000295:instrumentation* / Q000379:methods; D009666:Nose