A NEW TECHNIQUE FOR PLACEMENT OF NASOENTERAL FEEDING TUBES USING EXTERNAL MAGNETIC GUIDANCE

Objective: To evaluate a new technique in which a hand-held external m agnet is used to maneuver nasoenteral feeding tubes through the pyloru s and into the duodenum. Design: Prospective case series. Setting: Cri tical care units and medical and surgical wards of a university-affili ated community hospital. Patients: Thirty-five patients were entered i nto the study after the attending physician requested assistance in tu be placement. Interventions: A standard 12-Fr, 114-cm flexible nasoent eral feeding tube was modified by inserting a small magnet into the di stal tip, The tube was inserted per nares into the stomach, using trad itional technique. Next, an external magnet was placed over the right upper abdominal quadrant, at the midclavicular line to attract the tub e tip along the lesser curvature of the stomach, through the pyloric s phincter, and into the duodenum, Portable abdominal radiography perfor med immediately after the procedure confirmed the anatomic location of the tube tip. Measurements and Main Results: Forty-two intubations we re performed in 35 patients (in seven patients, the tube had to be rei nserted due to inadvertent removal or surgery). In 37 (88%) of 42 intu bations, the tube was passed through the pyloric sphincter and into th e duodenum on the first attempt, The mean procedure time was 15 +/- 9 mins (range 10 to 45), There were no complications related to the proc edure during the study period. Conclusions: This report describes a no vel technique of enteral feeding tube placement, using external magnet ic guidance, Transpyloric placement was achieved in 88% of cases, This reliable and convenient bedside method for rapid placement of the tub e into the duodenum allows prompt and safe initiation of enteral nutri tion.