Ultrasound control of the feeding tube position in newborns: a prospective study

Abstract

INTRODUCTION. In the last decade, there has been a rethinking of the value of nutritional support for neonatal intensive care patients. According to the American and European guidelines for nutritional therapy, enteral feeding is the preferred method of nutrition for patients with a functioning gastrointestinal tract. Preterm infants in critical ill have a low tolerance to during gastric feeding. Research shows that the use of transpiloric feeding is comparable in effectiveness to operative fundoplication. X-ray control method is used to confirm the correct position of the transpyloric tube. OBJECTIVES. The goal of this study was to evaluate the effectiveness and safety of ultrasound control of the transpyloric tube position in comparison with X-ray examination. MATERIALS AND METHODS. All patients included in the study had a low tolerance to enteral feeding through a gastric tube. The use of ultrasound during this manipulation provided an alternative method for monitoring the position of the tube without the X-ray control. Before the tube insertion procedure, the pyloric canal and postpyloric area were visualized in 100 % of patients. RESULTS. After the manipulation, according to sonography data, in 94.1 % of patients, the transpyloric tube was located outside the pyloric part of the stomach (in the duodenum). In more than half of the cases, there was a complete coincidence of the conclusions of radiography and ultrasound examination. At 41.2 % of cases, the radiologist could not determine the exact location of the distal end of the tube between the duodenum and jejunum. CONCLUSIONS. Usage transpyloric tube of ill infants may lead to improved treatment outcomes. The obtained data indicate that ultrasound imaging of the tube is statistically more reliable than X-ray control. The use of ultrasound to visualize the process of installing tube may exclude the additional use of radiography.