Early jejunal feeding by bedside placement of a nasointestinal tube significantly improves nutritional status and reduces complications in critically ill patients versus enteral nutrition by a nasogastric tube.
OBJECTIVE
Unguided nasojejunal feeding tube insertion success rates are low. Controversy persists about how to safely and efficiently perform enteral nutrition (EN) in critically ill patients. This study explores an innovative blind nasointestinal tube (NIT) insertion method and compares nasogastric and nasointestinal feeding.


METHODS
Seventy critically ill patients admitted to the intensive care unit (ICU) were divided randomly into a nasogastric tube group (NGT; n=35) and an NIT group (NIT; n=35). After bedside NGT and blind-type NIT insertion, tube position was assessed and EN was started on day 1. Patients' nutritional status parameters, mechanical ventilation duration, average ICU stay, nutritional support costs, and feeding complications were compared.


RESULTS
Pre-albumin and transferrin levels on days 7 and 14 were significantly higher in the NIT group than in the NGT group (p<0.01, p<0.05). Bloating, diarrhea, upper gastrointestinal bleeding, and liver damage did not differ significantly between groups (p>0.05). Interleukin-6 and tumor necrosis factor-α levels and APACHE II score were significantly lower in the NIT group than in the NGT group (p<0.01, p<0.05). Reflux and pneumonia incidences, mechanical ventilation duration, average ICU stay length, and nutritional support costs were significantly lower in the NIT group than in the NGT group (p<0.01).


CONCLUSIONS
Blind bedside NIT insertion is convenient and its use can effectively improve nutritional status, reduce feeding complications, and decrease nutritional support costs of critically ill patients.
Emergency Medicine Center, Affiliated Hospital of Jiangsu University, 438 Jiefang Road, Jiangsu 212001, China. Email: andiantong@163.com.
Bing
B
Wan
Department of General Surgery, the Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China.
Haiyan
H
Fu
Department of ICU, the Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China.
Jiangtao
J
Yin
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness / Q000628:therapy*; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007441:Intubation, Gastrointestinal; D007583:Jejunum; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011228:Prealbumin / Q000032:analysis; D011446:Prospective Studies; D012121:Respiration, Artificial; D014168:Transferrin / Q000032:analysis
D011228:Prealbumin; D014168:Transferrin