Dataset Information

Electromagnetic-guided versus endoscopic placement of post-pyloric feeding tubes: a systematic review and meta-analysis of randomised controlled trials.

ABSTRACT:

Background

Current evidence supporting the utility of electromagnetic (EM)-guided method as the preferred technique for post-pyloric feeding tube placement is limited. We conducted a meta-analysis to compare the performance of EM-guided versus endoscopic placement.

Methods

We searched several databases for all randomised controlled trials evaluating the EM-guided vs. endoscopic placement of post-pyloric feeding tubes up to 28 July 2020. Primary outcome was procedure success rate. Secondary outcomes included reinsertion rate, number of attempts, placement-related complications, tube-related complications, insertion time, total procedure time, patient discomfort, recommendation scores, length of hospital stay, mortality, and total costs.

Results

Four trials involving 536 patients were qualified for the final analysis. There was no difference between the two groups in procedure success rate (RR 0.97; 95% CI 0.91-1.03), reinsertion rate (RR 0.84; 95% CI 0.59-1.20), number of attempts (WMD - 0.23; 95% CI - 0.99-0.53), placement-related complications (RR 0.78; 95% CI 0.41-1.49), tube-related complications (RR 1.08; 95% CI 0.82-1.44), total procedure time (WMD - 18.09 min; 95% CI - 38.66-2.47), length of hospital stay (WMD 1.57 days; 95% CI - 0.33-3.47), ICU mortality (RR 0.80; 95% CI 0.50-1.29), in-hospital mortality (RR 0.87; 95% CI 0.59-1.28), and total costs (SMD - 1.80; 95% CI - 3.96-0.36). The EM group was associated with longer insertion time (WMD 4.3 min; 95% CI 0.2-8.39), higher patient discomfort level (WMD 1.28; 95% CI 0.46-2.1), and higher recommendation scores (WMD 1.67; 95% CI 0.24-3.10).

Conclusions

No significant difference was found between the two groups in efficacy, safety, and costs. Further studies are needed to confirm our findings.

Systematic review registration

PROSPERO ( CRD42020172427 ).

SUBMITTER: Wei Y

PROVIDER: S-EPMC7727211 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Electromagnetic-guided versus endoscopic placement of post-pyloric feeding tubes: a systematic review and meta-analysis of randomised controlled trials.

Wei Yaping Y Jin Zheng Z Zhu Ying Y Hu Wei W

Journal of intensive care 20201210 1

<h4>Background</h4>Current evidence supporting the utility of electromagnetic (EM)-guided method as the preferred technique for post-pyloric feeding tube placement is limited. We conducted a meta-analysis to compare the performance of EM-guided versus endoscopic placement.<h4>Methods</h4>We searched several databases for all randomised controlled trials evaluating the EM-guided vs. endoscopic placement of post-pyloric feeding tubes up to 28 July 2020. Primary outcome was procedure success rate. ...[more]

PMID: 33303005

Similar Datasets

Project description:BackgroundPost-pyloric enteral feeding reduces respiratory complications and shortens the duration of mechanical ventilation. Blind placement of post-pyloric enteral feeding tubes (EFT) in patients with critical illnesses is often the first-line method because endoscopy or fluoroscopy cannot be easily performed at bedside; however, difficult placements regularly occur. We reported an association between the stomach position caudal to spinal level L1-L2, evaluated by abdominal radiographs after placement, and difficult placement; however, this method could not indicate difficulty before EFT placement. The aim of our study was to evaluate the association between stomach position, estimated using computed tomography (CT) images taken before the blind placement of the post-pyloric EFT, and the difficulty of EFT placement.MethodsData from patients aged ≥ 20 years who underwent post-pyloric EFT in our intensive care unit were obtained retrospectively. Logistic regression analysis was used to evaluate the association between successful initial EFT placement and explanatory variables, including stomach position estimated by CT. Two cut-off values were used: caudal to L1-L2 based on a previous study and the best cut-off value calculated by the receiver operating characteristic curve. Variable selection was performed backward stepwise using Akaike's Information Criterion.ResultsOf the total of 453 patients who were enrolled, the success rate of the initial EFT placement was 43.5%. The adjusted odds ratio for successful initial EFT placement of the stomach position caudal to L1-L2 was 0.61 (95% confidence interval: 0.41-1.07). Logistic regression analysis, including the stomach position caudal to L2-L3, calculated as the best cut-off value, indicated that stomach position was an independent factor for failure of initial EFT placement (adjusted odds ratio, 0.55; 95% confidence interval: 0.33-0.91).ConclusionsStomach position evaluated using CT images was associated with successful initial post-pyloric EFT placement. The best cut-off value of the greater curvature of the stomach to predict the success or failure of the first attempt was spinal level L2-L3. Trial registration University Hospital Medical Information Network Clinical Trials Registry (UMIN000046986; February 28, 2022). https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000052151.

Dataset Information

Electromagnetic-guided versus endoscopic placement of post-pyloric feeding tubes: a systematic review and meta-analysis of randomised controlled trials.

Background

Methods

Results

Conclusions

Systematic review registration

Publications

Electromagnetic-guided versus endoscopic placement of post-pyloric feeding tubes: a systematic review and meta-analysis of randomised controlled trials.

Similar Datasets

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