Clinical usefulness of capnographic monitoring when inserting a feeding tube in critically ill patients: retrospective cohort studyReport as inadecuate




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BMC Anesthesiology

, 16:122

Critical care

Abstract

BackgroundIt is not rare for a small-bore feeding tube to be inserted incorrectly into the respiratory system in critically ill patients. Thus, monitoring is necessary to prevent respiratory malplacement of the tube. We investigated the utility of capnographic monitoring to prevent respiratory complications due to feeding tube mispositioning in critically ill patients.

MethodsThis study was a pre and post-interventional study, including 445 feeding tube placements events studied retrospectively in the medical and surgical intensive care units of the Samsung Medical Center. We compared outcomes between time periods before and after capnographic monitoring and documented any respiratory complications.

ResultsFeeding tubes were inserted in 275 cases without capnographic monitoring. Capnographic monitoring was performed in 170 cases. Sixteen patients 4% had respiratory complications of all tube placements. Feeding tube was inserted into the trachea in 11 2% patients and for a pneumothorax in five 1% patients. Fourteen cases of respiratory complications were detected in the control group 14-275, 5%, 10 tracheal insertions and four pneumothoraxes. Two respiratory complications were detected in the capnographic monitoring group 2-170, 1%, one tracheal insertion and one pneumothorax. Respiratory complications were detected less frequently in the capnographic monitoring group than that in the control group P = 0.035.

ConclusionsCapnographic monitoring is simple, easy to learn, and may be useful to prevent respiratory complications when placing a feeding tube in a critically ill patient.

KeywordsCapnographic monitoring Feeding tube Critically ill patient Pneumothorax AbbreviationsARDSAcute respiratory distress syndrome

CAM-ICUConfusion assessment method for the intensive care unit

CO2Carbon dioxide

EMElectromagnetic

ETCO2End tidal carbon dioxide

GCSGlasgow Coma Scale

ICUIntensive care unit

IQRInterquartile range

RASSRichmond Agitation Sedation Scale

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Author: Jeong-Am Ryu - Kyoungjin Choi - Jeong Hoon Yang - Dae-Sang Lee - Gee Young Suh - Kyeongman Jeon - Joongbum Cho - Chi Rya

Source: https://link.springer.com/







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