Objective Pulmonary misplacement during the blind insertion of enteral feeding tubes is frequent, particularly in ventilated and neurologically impaired patients. This is probably the first clinical study using the Kangaroo Feeding Tube with IRIS technology (IRIS) which incorporates a camera designed to provide anatomic landmark visualization during insertion. The study aim was to evaluate IRIS performance during bedside gastric placement. Methods This is the first prospective study to collect data on the use of IRIS. Twenty consecutive unconscious patients requiring enteral nutrition were recruited at a single center. IRIS placement was considered complete when a clear image of the gastric mucosa appeared. Correct placement was confirmed using a contrast-enhanced abdominal X-ray. To evaluate the device performance over time, the camera was activated every other day up to 17 d postplacement. Results In 7 (35%) patients, the trachea was initially visualized, requiring a second placement attempt with the same tube. The IRIS camera allowed recognition of the gastric mucosa in 18 (90%) patients. The esophagogastric junction was identified in one patient, while in a second patient the quality of visualization was poor. Contrast-enhanced X-ray confirmed the gastric placement of IRIS in all patients. IRIS allowed identification of gastric mucosa in 14 (70%) patients 3 d after placement. Performance progressively declined with time (P = 0.006, chi-square for trend). Conclusion IRIS placement could have spared X-ray confirmation in almost all patients and prevented misplacement into the airway in about one third. Visualization quality needs to be improved, particularly after the first week.

Mizzi, A., Cozzi, S., Beretta, L., Greco, M., Braga, M. (2017). Real-time image-guided nasogastric feeding tube placement: A case series using Kangaroo with IRIS Technology in an ICU. NUTRITION, 37, 48-52 [10.1016/j.nut.2016.09.002].

Real-time image-guided nasogastric feeding tube placement: A case series using Kangaroo with IRIS Technology in an ICU

Greco, Massimiliano;Braga, Marco
Ultimo
2017

Abstract

Objective Pulmonary misplacement during the blind insertion of enteral feeding tubes is frequent, particularly in ventilated and neurologically impaired patients. This is probably the first clinical study using the Kangaroo Feeding Tube with IRIS technology (IRIS) which incorporates a camera designed to provide anatomic landmark visualization during insertion. The study aim was to evaluate IRIS performance during bedside gastric placement. Methods This is the first prospective study to collect data on the use of IRIS. Twenty consecutive unconscious patients requiring enteral nutrition were recruited at a single center. IRIS placement was considered complete when a clear image of the gastric mucosa appeared. Correct placement was confirmed using a contrast-enhanced abdominal X-ray. To evaluate the device performance over time, the camera was activated every other day up to 17 d postplacement. Results In 7 (35%) patients, the trachea was initially visualized, requiring a second placement attempt with the same tube. The IRIS camera allowed recognition of the gastric mucosa in 18 (90%) patients. The esophagogastric junction was identified in one patient, while in a second patient the quality of visualization was poor. Contrast-enhanced X-ray confirmed the gastric placement of IRIS in all patients. IRIS allowed identification of gastric mucosa in 14 (70%) patients 3 d after placement. Performance progressively declined with time (P = 0.006, chi-square for trend). Conclusion IRIS placement could have spared X-ray confirmation in almost all patients and prevented misplacement into the airway in about one third. Visualization quality needs to be improved, particularly after the first week.
Articolo in rivista - Articolo scientifico
Complications; Critically ill patients; Enteral feeding; Feeding tube; Pulmonary misplacement; Adolescent; Adult; Aged; Aged, 80 and over; Animals; Critical Care; Critical Illness; Female; Humans; Intubation, Gastrointestinal; Male; Middle Aged; Prospective Studies; X-Rays; Young Adult; Enteral Nutrition; Intensive Care Units; Endocrinology, Diabetes and Metabolism; Nutrition and Dietetics
English
2017
37
48
52
none
Mizzi, A., Cozzi, S., Beretta, L., Greco, M., Braga, M. (2017). Real-time image-guided nasogastric feeding tube placement: A case series using Kangaroo with IRIS Technology in an ICU. NUTRITION, 37, 48-52 [10.1016/j.nut.2016.09.002].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/219083
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