Indicators of tubesite during feedings.
Indicators of tubesite during feedings.
复制标题
喂食期间管位点的指标。
DOI：
10.1097/01376517-200512000-00004
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
Oliver,DanaA
中科院分区：
文献类型：
--
作者：
Metheny,NormaA;Schnelker,Renée;McGinnis,Joan;Zimmerman,Georgia;Duke,Carolyn;Merritt,Barbara;Banotai,Mary;Oliver,DanaA
结肠;护士被迫在管饲期间定期决定饲管的位置;未能检测到位置不当的饲管可能会产生严重的后果。本研究旨在确定特定指标在何种程度上可以单独和共同区分经鼻或经口插入小口径喂养管的患者的胃和小肠放置。指标是从管插入部位延伸的管的长度以及从饲管抽出的抽吸物的特征（体积、外观和pH）。共有201名管饲重症患者参加了为期2-3天的研究。入选标准包括盲插小口径饲管的命令，开始连续喂养的命令，以及管位置的放射学确认。每天5次，测量以下变量：（a）从插入部位延伸的管路长度，（B）来自饲管的抽吸物体积，（c）抽吸物外观，和（d）抽吸物pH值。在进入研究时，85例患者有胃饲管，116例患者有小肠饲管。共尝试了2，754次变量的同时测量;在74.2%的胃管尝试和62.2%的小肠管尝试中获得了用于pH测试和颜色描述的足够液体。单变量分析表明，上述所有四个变量都能够区分胃和小肠插管部位。一个多变量的，强制进入，逻辑回归模型能够正确分类管网站的81%的预测。各种易于使用的床边方法可以在中等程度的置信度下用于区分连续喂养期间的胃管和小肠管放置。
colon; Nurses are forced to make decisions about feeding tube position at regular intervals during the delivery of tube feedings; failure to detect an improperly positioned feeding tube can have serious consequences. This study was designed to determine the extent to which specific indicators could singularly and collectively differentiate between gastric and small-bowel placement in patients with nasally or orally inserted small-bore feeding tubes. Indicators were the length of tubing extending from the tube's insertion site as well characteristics of aspirates withdrawn from the feeding tube (volume, appearance, and pH). A total of 201 critically ill tube-fed patients participated in the study for a period of 2-3 days. Among the inclusion criteria were an order for the blind insertion of a small-bore feeding tube, orders to start continuous feedings, and radiographic confirmation of tube location. Five times daily, the following variables were measured:(a) length of tubing extending from the insertion site,(b) volume of aspirate from the feeding tube,(c) appearance of the aspirate, and (d) pH of the aspirate. At the time of entry into the study, 85 patients had gastric feeding tubes and 116 patients had small-bowel feeding tubes. A total of 2,754 concurrent measurements of the variables were attempted; sufficient fluid for pH testing and color description was obtained in 74.2% of the attempts from gastric tubes and in 62.2% of the attempts from small-bowel tubes. Univariate analysis showed that all four of the variables described above were able to differentiate between gastric and small bowel tube sites. A multivariate, forced entry, logistic regression model was able to correctly classify tube site in 81% of the predictions. A variety of easy-to-use bedside methods can be used with a moderate degree of confidence to distinguish between gastric and small-bowel tube placement during continuous feedings.