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Abstract

Delayed gastric emptying is a common postoperative complication in critically ill patients that impedes successful administration of early enteral feeding. Transgastric jejunal feeding tubes (TJTs) simultaneously decompress the stomach while permitting postpyloric feedings. Earlier designs were associated with inadequate gastric decompression and reflux of feedings into the stomach; however, a new tube (Medical Innovations Corporation, Milpetas, CA) appears to be an improvement, thus warranting an evaluation of its safety and efficacy. TJTs were placed in 29 patients who were followed for complications associated with the tube. Seventeen problems occurred: three were due to user errors, six were due to mechanical dysfunction, and four tubes were dislodged. Ten patients had a nasogastric tube in addition to their TJT; however, only four of the nasogastric tubes were thought to be needed because of inadequate gastric drainage. The TJT adequately decompressed the stomach in most patients, allowing small-bowel feedings without the need for a separate gastrostomy. Education of hospital staff concerning the insertion and use of TJTs is necessary for optimal use of the tube.

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Transgastric Jejunal Feeding Tubes in Critically III Patients

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