Purpose: To determine the success rate for intensivist placed, fluoroscopically guided, post-pyloric feeding tubes and the accuracy of performer interpreted tube location compared to post-procedure abdominal radiograph results. Methods: Prospective data were collected on patients undergoing fluoroscopically guided, intensivist placed, post-pyloric feeding tubes. Performer interpreted feeding tube location during fluoroscopy was compared to radiologist interpreted tube location on confirmatory abdominal radiographs. Results: 30 patients underwent 35 bedside placements of post-pyloric feeding tubes under fluoroscopic guidance. The overall success rate for tube placement was 69% (24 of 35). The mean procedure and fluoroscopy times were 15.3 ± 9.4 and 7.1 ± 5.6 minutes, respectively. Intensivist interpretation of tube location on fluoroscopy concurred with the radiologist interpretation on the post procedure abdominal radiographs in 27/28 (96%) patients. One radiologist interpretation of tube location (gastric) proved inaccurate (post-pyloric) by bedside contrast study. Based on 1998 hospital charges, elimination of the confirmatory abdominal radiograph would save an estimated $210 per patient and $5880 for the entire cohort. Conclusions: These data suggest that fluoroscopically guided post-pyloric feeding tubes are an effective bedside procedure for enterai access in the Intensive Care Unit. Post-procedure abdominal radiographs are not required to confirm tube location prior to the institution of feedings. Clinical Implications: This bedside technique offers a safe and cost-effective method for enteral access in the Intensive Care Unit.
|Issue number||4 SUPPL.|
|State||Published - Oct 1998|