Semi-automated ultrasound guidance applied to nasogastrojejunal tube replacement for enteral nutrition in critically ill adults

Abstract

Background and objective: At present, the enteral nutrition approaches via nose and duodenum (or nose and jejunum) are the preferred method of nutritional support in the medical engineering field, given the superiority of in line with physiological processes and no serious complication. In this study, the authors adopted saline as the acoustic window, and gave enteral nutrition support to critically ill patients, via the nasogastrojejunal approach guided by semi-automated ultrasound. These above patients benefited a lot from this kind of nutrition support treatment, and we aimed to report the detailed information. Methods: Critically ill patients (n = 41) who had been treated with hospitalized intestine nutrition were identified. The Apogee 1200 ultrasonic diagnostic apparatus, and nasogastrojejunal tubes were adopted to carry out intestine nutrition treatment guided by semi-automated ultrasound. In order to confirm the specific positions of cardia, gastric body, antrum of stomach, and pylorus, the semi-automated ultrasound was utilized to probe the stomach cavity. And then, the ultrasonic probe was placed in the cardia location, and the nasogastrojejunal tube was slowly inserted through the metal thread. After operation, the nursing service satisfaction of patients and mean operation time were calculated, respectively. Results: All the patients were treated with enteral nutrition via nasogastrojejunal tube, and the whole procedure was under the guidance of semi-automated ultrasonography. The end of the feeding tube is attached to the surface of the stomach with a greater curvature, which can be bent on account of a no gastric peristalsis squeeze function, and thereby were prevented from entering into the antrum and pylorus locations. After this procedure, the mental thread was taken out, and the tube was pushed forward by a "drift" approach in order to allow it to enter into the intestine. The total nursing service satisfaction of patients was 90.24%, and the total incidence of adverse reactions was 17.07%. Conclusions: In summary, the application of saline can be taken as sound window, and the metal wire as the tracking target, the bedside nasogastrojejunal tube guided by semi-automated ultrasound is an effective feeding tube placement method, with relatively good clinical application value in medical engineering.