ENDOSCOPIC NASOENTERAL FEEDING TUBE PLACEMENT FOLLOWING CARDIOTHORACIC SURGERY

Our purpose was to evaluate the safety and efficacy of nasoenteral fee ding tube placement in cardiothoracic surgery patients. This is a retr ospective analysis of 15 critically ill cardiothoracic surgery patient s who underwent endoscopic placement of an enteral feeding tube beyond the proximal duodenum for maintenance of nutrition. Twenty-five entri flex 10-F nasoenteral tubes were placed endoscopically using a modifie d technique far into the distal duodenum, and the placement was confir med radiographically. Mean patient age was 71 years. Seven were males and 8 females. Eleven had undergone coronary artery bypass surgery, tw o aortic valve replacement, and two aortic aneurysm repair. The mean d uration of tube function was 8.5 days and mean duration of tube feedin g was 15.7 days. Of the total 15 patients, 7 required replacement due to various reasons, the most common being self extubation by the patie nt and malpositioning after initial placement. No cardiac complication s or any other complications were noted directly related to the endosc opic procedure. In eight patients, the mean serum albumin level did no t change [before: 2.5mg/dL, after: 2.6mg/dL] for the short time (avg. 8.5 days) the tube was functional. Conclusions: 1) Endoscopic placemen t of the nasoenteral tubes is a safe method of providing enteral nutri tion in critically ill cardiothoracic. surgery patients. 2) Benefits o f nasoenteral tubes compared to nasogastric tubes remain unproven, and frequent repositioning of nasoenteral tubes is required. 3) A prospec tive comparison of nasoenteral and nasogastric tubes is warranted.