Bedside Naso-Jejunal Tube Placement for Patients with Upper Gastrointestinal Fistula: High Success and Safety
نویسندگان
1 Medicinal School of Chinese PLA, Beijing 100853, China
2 Department of Critical Care Medicine, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
3 Department of Critical Care Medicine, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
4 Department of Gastroenterology and Hepatology, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
5 Department of Critical Care Medicine, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
6 Department of Internal Medicine, the Fourth Hospital of Shijiazhuang (Maternal Hospital Affiliated to Hebei Medical University), No.16, Tangu North Street, Shijiazhuang City, Hebei Province,050031,China
7 Department of Critical Care Medicine, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
doi
10.22034/ircmj.2024.199360چکیده
Background and Objectives: Upper gastrointestinal fistula (UGF) secondary to surgery or other condition accounts for approximately 4–20%, and the associated mortality can be as high as 80%. UGF often occurs secondary to surgery, trauma, tumor, radiation/laser therapy, or acute and chronic inflammation of the chest and abdomen. This study aimed to explore a safe and effective method of bedside blind naso-jejunal tube placement in patients with UGF. Methods: A single-center, prospective, and observational study was conducted on patients who met the inclusion criteria (received auscultation-assisted and/or guide wire exchanged placement of the naso-jejunal tube). All patients were administered an intravenous injection of 10 mg metoclopramide prior to 10 min of procedure. Abdominal X-ray was performed to confirm the location of the catheter tip after the procedure was completed. End points of the investigation included the success rate of tube placement, length of insertion, and duration of placement. Operational-related adverse events or complications were also evaluated. Results: Twenty-three patients were included in this study. Naso-jejunal tube was successfully placed in 21 patients, and the success rate was 91.3%. The success rate at the first attempt was 87.0%. The average duration and tube depth of the placement was 19.7±6.9 min and 103.3±9.0 cm. The incidence of adverse events was 13.0%, and no serious adverse events or complications occurred during the procedures. Conclusion: The success rate of bedside auscultation-assisted and guide wire-exchanged method in patients with UGF was relatively high, and the operation was relatively simple and easy to carry out.
