The use of the Cortrak Enteral Access System™ for post-pyloric (PP) feeding tube placement in a Burns Intensive Care Unit

Hemington-Gorse, Sarah; Sheppard, NN; Martin, R.; Shelley, Odhran; Philp, Bruce; Dziewulski, Peter

doi:10.1016/j.burns.2010.07.011

Cited by 34 publications

(32 citation statements)

References 19 publications

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“…This is comparable to critically ill patients admitted because of other injuries/illnesses [17]. It has been suggested that feeding can be continued during all procedures except those that require airway manipulation, or increased to compensate for these fasting periods [18,19]. Based on our data such practices may be particularly beneficial in patients' post-burn.…”

Section: Discussionsupporting

confidence: 68%

International observational study of nutritional support in mechanically ventilated patients following burn injury

Czapran

Headdon

Deane

et al. 2015

Burns

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Section: Discussionsupporting

confidence: 68%

International observational study of nutritional support in mechanically ventilated patients following burn injury

Czapran

Headdon

Deane

et al. 2015

Burns

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“…This review of the literature of EMS-EAS compared with blind placement suggests that EMS-EAS can reduce the risk of feeding into the lungs, pneumothorax and time to commence feeding. More rapid and safer tube insertion reduces morbidity and is cost effective compared to blind placement and fluoroscopy using a variety of estimates, settings, countries and outcomes [5, 18, 20–27]. …”

Section: Discussionmentioning

confidence: 99%

“…Eliminating these delays helps patients start tube feeding more rapidly, thereby increasing the proportion that attain their caloric and nutrient targets, and minimising delays to the start of hydration and medication [18]. …”

Section: Introductionmentioning

confidence: 99%

Electromagnetic Sensor-Guided Enteral Access Systems: A Literature Review

et al. 2015

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Enteral feeding is the nutritional support of choice for acutely ill patients with functional gastrointestinal tracts who are unable to swallow. Several benefits including reduced mortality and length of hospital stay have been associated with early initiation of enteral feeding. However, misplacement of conventional nasoenteric tubes is relatively common and can result in complications including pneumothorax. In addition, the need to confirm the position by X-ray can delay the start of using the tube. Eliminating these delays can help patients start feeding, and minimise the adverse impact on initiating hydration and medication. The purpose of this review was to critically examine whether electromagnetic sensor-guided enteral access systems (EMS-EAS) can help overcome the challenges of conventional nasoenteric feeding tube placement and confirmation. The Royal Society of Medicine’s library performed two searches on Medline (1946–March 2014) and Embase (1947–March 2014) covering all papers on Cortrak or electromagnetic or magnetic guidance systems for feeding tubes in adults. Results from the literature search found an agreement between the radiographic and EMS-EAS confirmation of placement. EMS-EAS virtually eliminated the risk of misplacement and pneumothorax was not reported. In addition, studies showed a small decrease in the number of X-rays with EMS-EAS and a reduced average time to start feeding compared with blind placement. This review suggests that EMS-EAS reduces several complications associated with the misplacement of nasoenteric feeding tubes, and that there could be considerable improvements in mortality, morbidity, patient experience and cost if EMS-EAS is used instead of conventional methods.

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“…Various combinations of key words used in the search included electromagnetic phenomena, enteral nutrition, instrumentation, gastrointestinal, point-ofcare testing, pneumothorax, and Cortrak. Fifteen published studies 1,[4][5][6][7][8][9][10][11][12][13][14][15][16][17] were found that evaluated the effectiveness of an ETP device in determining tube location. These studies were reviewed for any reference to detection of bronchopulmonary placements.…”

Section: Methodsmentioning

confidence: 99%

“…3 Researchers in multiple studies have evaluated the effectiveness of an electromagnetic tube placement (ETP) device in distinguishing between tube placement in the stomach and in the small bowel. 1,[4][5][6][7][8][9][10][11][12][13][14][15][16][17] However, fewer studies have involved evaluation of the effectiveness of an ETP device in detecting bronchopulmonary placements. 1,6,11,12,14,16 Purpose This study had 2 purposes: 1.…”

mentioning

confidence: 99%

Effectiveness of an Electromagnetic Feeding Tube Placement Device in Detecting Inadvertent Respiratory Placement

Metheny

Meert

2014

American Journal of Critical Care

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Background Use of technology capable of electromagnetically tracking advancement of a feeding tube on a monitoring screen during insertion may enable detection of deviation of the tube from the midline as it advances through the chest, possibly indicating entry of the tube into the right or left main bronchus. Purposes To describe (1) published peer-reviewed studies that report on the detection of malpositioned tubes inserted by an electromagnetic tube placement device, and (2) events reported to the US Food and Drug Administration’s Manufacturer and User Facility Device Experience (MAUDE) database regarding use of such a device. Methods An Ovid MEDLINE search was conducted to locate peer-reviewed studies published between 2007 and 2012 that referred to use of an electromagnetic tube placement device to detect inadvertent respiratory placements of feeding tubes. In addition, an online search of the MAUDE database was conducted for the years 2007 through 2012. Results The Ovid MEDLINE search yielded 6 studies that referred to respiratory placements; no cases of pneumothorax were reported. The MAUDE database search yielded 21 adverse events associated with use of an electromagnetic tube placement device (including 17 cases of pneumothorax and 2 deaths). As the MAUDE database relies on voluntary reports, this number should not be construed as the incidence of malpositioned tubes during this period. Conclusions The ability of clinicians to place feeding tubes correctly by using an electromagnetic tube placement device varies. Thus, it is reasonable to question the wisdom of eliminating radiographic confirmation of tube position before starting feedings.

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The use of the Cortrak Enteral Access System™ for post-pyloric (PP) feeding tube placement in a Burns Intensive Care Unit

Cited by 34 publications

References 19 publications

International observational study of nutritional support in mechanically ventilated patients following burn injury

International observational study of nutritional support in mechanically ventilated patients following burn injury

Electromagnetic Sensor-Guided Enteral Access Systems: A Literature Review

Effectiveness of an Electromagnetic Feeding Tube Placement Device in Detecting Inadvertent Respiratory Placement

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