Multivariate analysis of factors associated with the successful prediction of initial blind placement of a nasointestinal tube in the stomach based on X-ray imaging: a retrospective, single-center study.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968547 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-230X (Electronic) Linking ISSN: 1471230X NLM ISO Abbreviation: BMC Gastroenterol Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Intubation, Gastrointestinal*/methods ; Enteral Nutrition*/methods; Humans ; Retrospective Studies ; Female ; Male ; Middle Aged ; Aged ; Multivariate Analysis ; Stomach/diagnostic imaging ; Adult ; Intensive Care Units

Background: Patients in the intensive care unit (ICU) are highly susceptible to malnutrition, and while enteral nutrition via nasogastric tube is the preferred method, there is a risk of inadvertent reflux and aspiration. Therefore, clinicians have turned to nasointestinal tubes (NET) for enteral nutrition as an alternative option. But the precise localization of NET presents an ongoing challenge. We proposed an innovative approach to provide a valuable reference for clinicians involved in NET placement.
Method: Data were obtained retrospectively from the medical records of adult patients with a high risk of aspiration or gastric feeding intolerance who had a NET placed in the ICU of Zhejiang Provincial People's Hospital between October 1, 2017, and October 1, 2023. The collected data were subjected to statistical analysis using SPSS and R software.
Result: There were 494 patients who met the inclusion and exclusion criteria. The first-pass success rate was 81.4% (n = 402). The success of a patient's initial NET placement was found to be associated with Angle SPC and Distance CP, as determined by univariate analysis (25.6 ± 16.7° vs. 41.9 ± 18.0°, P < 0.001; 40.0 ± 26.2 mm vs. 62.0 ± 31.8 mm, P < 0.001, respectively). By conducting a multivariate regression analysis, we identified a significant association between pyloric types and the success rate of placing NET (OR 29.559, 95%CI 14.084-62.038, P < 0.001).
Conclusion: Angle SPC, Distance CP, and the type of pylorus are independently associated with successful initial placement of NET. Besides, patients with the outside type of pylorus (OP-type) exhibit a higher rate of initial placement success.
(© 2024. The Author(s).)

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2023KY018 and 2022KY549 Zhejiang Medical Association; 2021KY485 Zhejiang Medical Association; 2022KY588 Zhejiang Medical Association; 2022KY497 Science and Technology Program of Zhejiang Province; LQ20H15010 Science Fund for Distinguished Young Scholars of Zhejiang Province

Keywords: Blind placement; Intensive care unit; Nasointestinal tube; Post-pyloric feeding

Date Created: 20240823 Date Completed: 20240824 Latest Revision: 20240826

20250114

PMC11342475

10.1186/s12876-024-03363-z

39179985