Magnetically guided nasoenteral feeding tubes: A new technique

Our objective was to evaluate a new technique for the bedside placement of nasoenteral feeding tubes into the duodenum using an external hand-held mag net to maneuver the tube from the stomach to the distal duodenum. We conduc ted a prospective case series of 20 consecutive patients requiring nasoente ral tube feeding in the intensive care units of a university-affiliated hos pital. Twenty patients were entered into the study after the attending phys ician requested assistance in tube placement. A flexible nasoenteral feedin g tube (12 F), modified to include a magnet and a magnetic field sensor in the distal tip connected by a thin insulated wire to a small light at the p roximal end, was passed per nares into the stomach. A larger hand-held magn et held over the epigastrium was used to magnetically "capture" the tube ti p, indicated by the illumination of the proximal light. The tube tip was th en maneuvered by the hand-held magnet along the lesser curvature of the sto mach, through the pylorus, and into the duodenum. Procedure time and anatom ic location of the tube tip as determined by an abdominal radiograph was re corded. The 12 men and eight women had a mean age of 60 years (range 30-84) . The procedure time averaged 9.6 minutes (range 1-30). In 19 of the 20 pat ients (95%) radiographs revealed successful placement of the tip of the fee ding tube into the duodenum. There were no complications related to the pro cedure. Using a novel magnetically guided nasoenteral feeding tube transpyl oric tube placement was achieved in 95 per cent of cases with an average pr ocedure time of 9.6 minutes. This new and inexpensive bedside technique wil l allow prompt and safe initiation of enteral nutrition.