Nasogastric bridles are associated with improved tube‐related outcomes in children

Abstract

Objective To compare tube‐related outcomes in children with standard tape vs nasal bridle securement of nasogastric tubes (NGTs). Study Design This was a single‐center, retrospective, correlational study of outcomes from the time of NGT placement until full oral feeds or durable‐tube placement. Outcomes of interest included NGT dislodgments, length of stay, emergency department (ED) encounters, radiographic exposures, and adverse skin outcomes. Negative binomial regression and logistic regression were used to analyze differences between groups. Results Five hundred eighty‐two children had NGTs secured traditionally (43% female; age at therapy initiation of 2.6 months [SD 8.1]), and 173 received nasal bridles (55.5% female; age at therapy initiation of 8.4 months [SD 11.8]). Children with bridled NGTs were 16.67 times less likely to experience one or more dislodgments (odds ratio [OR] = 0.06; 95% CI, 0.04–0.09); 2.5 times less likely to have one more ED visit (OR = 0.4; 95% CI, 0.19–0.82), and 4.76 times less likely to require one more radiographic exposure (OR = 0.21; 95% CI, 0.14–0.33) than unbridled children (all P values < 0.02). The mean initial hospital length of stay was 28 and 54 days in the bridled‐NGT and standard‐care groups, respectively (P < 0.001). Overall, 62.4% children with bridled NGTs and 77.1% children with unbridled NGTs progressed to full oral feedings and discontinued therapy (P < 0.001). Adverse skin outcomes were rare in both groups. Conclusion Children with bridled NGTs experienced fewer dislodgments, hospital days, ED encounters, and radiographic exposures than unbridled NGTs. Most children in both groups progressed to full oral feedings.

Risk factors associated with the initial unplanned removal of orogastric tubes in NICU: A Single Center Study in China

“…Unplanned removal of orogastric tubes (UROGTs) is de ned as the unintentional removal or accidental displacement of the tube. The event is associated with feeding tube misplacement, thus increasing the burden on the healthcare system as a result of repeat insertions, prolonging the hospital stay and increasing the risk of infection [12]. In infants, repeated insertion as a result of UROGTs may increase the risk of radiation exposure and risk of injury to the esophagus and stomach [13].…”