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Dysphagia
Published in: Dysphagia 3/2015

Open Access 01-06-2015 | Review Article

Electromagnetic Sensor-Guided Enteral Access Systems: A Literature Review

Authors: David Smithard, Nicholas A. Barrett, David Hargroves, Stuart Elliot

Published in: Dysphagia | Issue 3/2015

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Abstract

Enteral feeding is the nutritional support of choice for acutely ill patients with functional gastrointestinal tracts who are unable to swallow. Several benefits including reduced mortality and length of hospital stay have been associated with early initiation of enteral feeding. However, misplacement of conventional nasoenteric tubes is relatively common and can result in complications including pneumothorax. In addition, the need to confirm the position by X-ray can delay the start of using the tube. Eliminating these delays can help patients start feeding, and minimise the adverse impact on initiating hydration and medication. The purpose of this review was to critically examine whether electromagnetic sensor-guided enteral access systems (EMS-EAS) can help overcome the challenges of conventional nasoenteric feeding tube placement and confirmation. The Royal Society of Medicine’s library performed two searches on Medline (1946–March 2014) and Embase (1947–March 2014) covering all papers on Cortrak or electromagnetic or magnetic guidance systems for feeding tubes in adults. Results from the literature search found an agreement between the radiographic and EMS-EAS confirmation of placement. EMS-EAS virtually eliminated the risk of misplacement and pneumothorax was not reported. In addition, studies showed a small decrease in the number of X-rays with EMS-EAS and a reduced average time to start feeding compared with blind placement. This review suggests that EMS-EAS reduces several complications associated with the misplacement of nasoenteric feeding tubes, and that there could be considerable improvements in mortality, morbidity, patient experience and cost if EMS-EAS is used instead of conventional methods.
Appendix
Available only for authorised users
Literature
1.
Krenitsky J (2011) Blind Bedside Placement of Feeding Tubes: Treatment or Threat?. Pract Gastroenterol 32–42
2.
Rao M, Kallam R, Arsalanizadeh R, Gatt M, MacFie J (2009) Placing of feeding tubes by the bedside using an electromagnetic sensing device. Br J Intensiv Care Summer 54–59
3.
Sparks DA, Chase DM, Coughlin LM, Perry E. Pulmonary Complications of 9931 Narrow-Bore Nasoenteric Tubes During Blind Placement: A Critical Review. J Parenter Enteral Nutr. 2011;35(5):625–9. doi:10.​1177/​0148607111413898​.CrossRef
4.
Harvey SE, Parrott F, Harrison DA, Bear DE, Segaran E, Beale R, Bellingan G, Leonard R, Mythen MG, Rowan KM. Trial of the route of early nutritional support in critically ill adults. N Engl J Med. 2014;. doi:10.​1056/​NEJMoa1409860.PubMedCentral
5.
Gray R, Tynan C, Reed L, Hasse J, Kramlich M, Roberts S, Suneson J, Thompson J, Neylon J. Bedside electromagnetic-guided feeding tube placement: an improvement over traditional placement technique? Nutr Clin Pract. 2007;22(4):436–44. doi:10.​1177/​0115426507022004​436.PubMedCrossRef
6.
7.
8.
Dennis M, Lewis S, Warlow C. Effect of timing and method of enteral tube feeding for dysphagic stroke patients (FOOD): a multicentre randomised controlled trial. Lancet. 2005;365(9461):764–72.PubMedCrossRef
9.
National Patient Safety Agency (NPSA) Reducing the harm caused by misplaced nasogastric feeding tubes in adults, children and infants NPSA/2011/PSA002 10 March 2011.
10.
Taylor S, Allan K, McWilliam H, Manara A, Brown J, Toher D, Rayner W (2014) Confirming nasogastric tube position: electromagnetic tracking. Br J Nurs 23 (7):352, 354–358
11.
12.
Metheny NA, Meert KL, Clouse RE. Complications related to feeding tube placement. Curr Opin Gastroenterol. 2007;23(2):178–82.PubMedCrossRef
13.
Roberts S, Echeverria P, Gabriel SA. Devices and techniques for bedside enteral feeding tube placement. Nutri clin pract. 2007;22(4):412–20.CrossRef
14.
Gatt M, MacFie J. Bedside postpyloric feeding tube placement: a pilot series to validate this novel technique. Crit Care Med. 2009;37(2):523–7.PubMedCrossRef
15.
Aguilar-Nascimento Jd, Kudsk K. Clinical costs of feeding tube placement. J Parenter Enteral Nutri. 2007;31:269–73.CrossRef
16.
17.
de González AB, Darby S. Risk of cancer from diagnostic X-rays: estimates for the UK and 14 other countries. Lancet. 2004;363(9406):345–51.CrossRef
18.
19.
McWhirter L, Healy M, Price M (2011) To feed or not to feed, That is the question… Intensive Care Med 37 (Suppl 1) S198
20.
Lei K, Smith J, Camporota L, Beale R. Using cortrak magnetic device to facilitate early enteral nutrition in critically ill patients. Crit Care. 2007;11(suppl 2):P151.PubMedCentralCrossRef
21.
Dolan A, O’Hanlon C, OR J. An evaluation of the Cortrak Enteral Access System in our Intensive Care. Ir Med J. 2012;105:5.
22.
Stockdale W, Nordbeck S, Kadro O, Hale L (2007) Quality and Safety Improvement Project Utilizing Electromagnetic Tube Placement and Tube Securement Systems Poster presented at American Society for Parenteral and Enteral Nutrition Meeting.
23.
Kless S, Hale L, Nordbeck S, Stockdale W, Kadro O. Has the introduction of an electromagnetic tube placement system reduced inappropriate parenteral nutrition utilization and associated costs? Nutr Clin Pract. 2009;24(1):153–4 abstract 191.
24.
MacKay P, Villaran Y, Hampton D, Griffith D (2009) Corpak with Cortrak. Poster presented at American Society for Parenteral and Enteral Nutrition Meeting February 1–4 New Orleans.
25.
Hillard A, Waddell J, Metzler M, McAlpin D. Fluoroscopically guided nasoenteric feeding tube placement versus bedside placement. South Med J. 1995;88:425–8.PubMedCrossRef
26.
Brown A-M, Handwork C, Perebzak C, Nagy K, Gothard M (2012) Efficacy and efficiency of CORTRAK® post pyloric nasal tube device in reducing radiation exposure and resource utilization in the PICU. Crit Care Med Supp 40(12):abstract 332
27.
McCutcheon K, Fuchs J, Klink V. Small-bore feeding tube placement: A team approach with an electromagnetic placement device vs traditional or modified blind placement. J Parenter Enteral Nutr. 2011;35(5):636–42.CrossRef
28.
Ackerman M, Mick D, Bianchi C, Chiodo V, Yeager C. The effectiveness of the CORTRAK™ device in avoiding lung placement of small bore enteral feeding tubes. Am J Crit Care. 2004;13:268.
29.
30.
Taylor S, Manara A, Brown J. Nasointestinal placement versus prokinetic use when treating delayed gastric emptying in ICU patients. Br J Intensive Care. 2010;20:38–44.
31.
Hazell L, Shakir SA. Under-reporting of adverse drug reactions : a systematic review. Drug Saf. 2006;29(5):385–96.PubMedCrossRef
32.
33.
Taylor SJ, Manara AR, Brown J. Treating delayed gastric emptying in critical illness: metoclopramide, erythromycin, and bedside (cortrak) nasointestinal tube placement. J Parenter Enteral Nutr. 2010;34(3):289–94. doi:10.​1177/​0148607110362533​.CrossRef
34.
Koopmann MC, Kudsk KA, Szotkowski MJ, Rees SM. A team-based protocol and electromagnetic technology eliminate feeding tube placement complications. Ann Surg. 2011;253(2):297–302.CrossRef
35.
El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2014;63(6):871–80.PubMedCentralPubMedCrossRef
36.
Duflou A, Spanier B, Mathus-Vliegen E (2007) The placement of nasoduodenal feeding tubes by nurses with the assistance of an electromagnetic system (Cortrak™) Poster presented at the 11th Meeting of the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Paris, France 27-29 October.
37.
Deane AM, Fraser RJ, Young RJ, Foreman B, O’Conner SN, Chapman MJ. Evaluation of a bedside technique for postpyloric placement of feeding catheters. Crit Care Resusc. 2009;11(3):180–3.PubMed
38.
39.
Boyer N, McCarthy MS, Mount CA. Analysis of an electromagnetic tube placement device versus a self-advancing nasal jejunal device for postpyloric feeding tube placement. J Hosp Med. 2014;9(1):23–8. doi:10.​1002/​jhm.​2122.PubMedCrossRef
40.
Phang J, Marsh W, Prager R (2006) Feeding tube placement with the aid of a new electromagnetic transmitter (S082). J Enteral Parenteral Nutr 30 (number 2):S082
41.
Powers J, Luebbehusen M, Spitzer T, Coddington A, Beeson T, Brown J, Jones D. Verification of an electromagnetic placement device compared with abdominal radiograph to predict accuracy of feeding tube placement. J Parenteral Enteral Nutr. 2011;35(4):535–9. doi:10.​1177/​0148607110387436​.CrossRef
42.
Priestley G, Adams B, Coleman J, Steiger C An evaluation of the Corpak MedSystems tube placement device as an aid for placement of small bowel feeding tubes. Poster presented at Arizona Nurses Association (AZNA), September, 2005.
43.
Stockdale W, Nordbeck S, Kadro O, Hale L, CNSN R. Nasoenteric feeding tube insertion utilizing an electromagnetic tube placement system. Nutr clin pract. 2007;22:118.
44.
Marderstein EL, Simmons RL, Ochoa JB. Patient safety: effect of institutional protocols on adverse events related to feeding tube placement in the critically ill1 1 No competing interests declared. J Am Coll Surg. 2004;199(1):39–47.PubMedCrossRef
45.
McWey RE, Curry NS, Schabel SI, Reines HD. Complications of nasoenteric feeding tubes. Am J Surg. 1988;155(2):253–7.PubMedCrossRef
46.
Rassias AJ, Ball PA, Corwin HL. A prospective study of tracheopulmonary complications associated with the placement of narrow-bore enteral feeding tubes. Crit Care. 1998;2(1):25–8.PubMedCentralPubMedCrossRef
47.
Powers J, Fischer MH, Ziemba-Davis M, Brown J, Phillips DM. Elimination of radiographic confirmation for small-bowel feeding tubes in critical care. Am J Crit Care. 2013;22(6):521–7. doi:10.​4037/​ajcc2013755.PubMedCrossRef
48.
Rivera R, Campana J, Hamilton C, Lopez R, Seidner D. Small bowel feeding tube placement using an electromagnetic tube placement device: accuracy of tip location. J Parenter Enteral Nutr. 2011;35(5):636–42. doi:10.​1177/​0148607110386047​.CrossRef
49.
Trottier S, Karmally Z, Cyron M, Fowler K, Javaux V (2011) Electromagnetic guided feeding tube insertion: Enhancing patient safety. Poster presented at 40th Society of Critical Care Medicine Conference; Jan 15–19; San Diego, Abstract 264.
50.
Cresci G, Martindale R. Bedside placement of small bowel feeding tubes in hospitalized patients: a new role for the dietitian. Nutrition. 2003;19(10):843–6.PubMedCrossRef
51.
Holzinger U, Brunner R, Miehsler W, Herkner H, Kitzberger R, Fuhrmann V, Metnitz PGH, Kamolz L-P, Madl C. Jejunal tube placement in critically ill patients: a prospective, randomized trial comparing the endoscopic technique with the electromagnetically visualized method. Crit Care Med. 2011;39(1):73–7. doi:10.​1097/​CCM.​1090b1013e3181fb​1097b1095f.PubMedCrossRef
52.
Kaffarnik MF, Lock JF, Wassilew G, Neuhaus P. The use of bedside electromagnetically guided nasointestinal tube for jejunal feeding of critical ill surgical patients. Technol Health Care. 2013;21(1):1–8. doi:10.​3233/​THC-120704.PubMed
53.
Mathus-Vliegen EMH, Duflou A, Spanier MBW, Fockens P. Nasoenteral feeding tube placement by nurses using an electromagnetic guidance system (with video). Gastrointest Endosc. 2010;71(4):728–36.PubMedCrossRef
54.
Young R, Chapman M, Fraser R, Vozzo R, Chorley D, Creed S. A novel technique for post-pyloric feeding tube placement in critically ill patients: a pilot study. Anaesth Intensive Care. 2005;33:229–34.PubMed
Metadata
Title
Electromagnetic Sensor-Guided Enteral Access Systems: A Literature Review
Authors
David Smithard
Nicholas A. Barrett
David Hargroves
Stuart Elliot
Publication date
01-06-2015
Publisher
Springer US
Published in
Dysphagia / Issue 3/2015
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-015-9607-4

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