Integrated real-time imaging system, ‘IRIS’, Kangaroo feeding tube: a guide to placement and image interpretation
Background Lung complications occur in 0.5% of the millions of blind tube placements. This represents a major health burden. Use of a Kangaroo feeding tubes with an ‘integrated real-time imaging system’ (‘IRIS’ tube) may pre-empt such complications. We aimed to produce a preliminary operator guide t...
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| Language: | English |
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BMJ Publishing Group
2021-10-01
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| Series: | BMJ Open Gastroenterology |
| Online Access: | https://bmjopengastro.bmj.com/content/8/1/e000768.full |
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| author | Stephen Taylor Zeino Zeino Jules Brown Kaylee Sayer Danielle Milne |
| author_facet | Stephen Taylor Zeino Zeino Jules Brown Kaylee Sayer Danielle Milne |
| author_sort | Stephen Taylor |
| collection | DOAJ |
| description | Background Lung complications occur in 0.5% of the millions of blind tube placements. This represents a major health burden. Use of a Kangaroo feeding tubes with an ‘integrated real-time imaging system’ (‘IRIS’ tube) may pre-empt such complications. We aimed to produce a preliminary operator guide to IRIS tube placement and interpretation of position.Methods In a single centre, IRIS tubes were prospectively placed in intensive care unit patients. Characteristics of tube placement and visualised anatomy were recorded in each organ to produce a guide.Results Of 45 patients having one tube placement, 3 were aborted due to refusal (n=1) or inability to enter the oesophagus (n=2). Of 43 tubes placed beyond 30 cm, 12 (28%) initially entered the respiratory tract but all were withdrawn before reaching the main carina. We identified anatomical markers for the nasal or oral cavity (97.8%), respiratory tract (100%), oesophagus (97.6%), stomach (100%) and intestine (100%). Organ differentiation was possible in 100%: trachea-oesophagus, oesophagus-stomach and stomach-intestine. Gastric tube position was confirmed by aspiration of fluid with a pH <4.0 and/ or X-ray. Trauma was avoided in 13.6% by identifying that the tube remained in the nasal lumen in the presence of a base of skull fracture (n=3) and in the stomach in the presence of recently bleeding polyps or mucosa (n=3). A systematic guide was produced from records of tube placement and interpretation of anatomical images.Conclusion By permitting real-time confirmation of tube position, direct vision may reduce risk of lung complications. The preliminary operator guide requires validation in larger studies. |
| format | Article |
| id | doaj-art-ef31511d0c70494e8e8d82cc3d46dce6 |
| institution | Kabale University |
| issn | 2054-4774 |
| language | English |
| publishDate | 2021-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Gastroenterology |
| spelling | doaj-art-ef31511d0c70494e8e8d82cc3d46dce62024-12-07T16:15:10ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742021-10-018110.1136/bmjgast-2021-000768Integrated real-time imaging system, ‘IRIS’, Kangaroo feeding tube: a guide to placement and image interpretationStephen Taylor0Zeino Zeino1Jules Brown2Kaylee Sayer3Danielle Milne4Department of Nutrition and Dietetics, North Bristol NHS Trust, Bristol, UKSouthmead Hospital, Bristol, UKDepartment of Anaesthetics, North Bristol NHS Trust, Bristol, UKDepartment of Nutrition and Dietetics, North Bristol NHS Trust, Bristol, UK2 Intensive Care Unit, North Bristol NHS Trust, Bristol, UKBackground Lung complications occur in 0.5% of the millions of blind tube placements. This represents a major health burden. Use of a Kangaroo feeding tubes with an ‘integrated real-time imaging system’ (‘IRIS’ tube) may pre-empt such complications. We aimed to produce a preliminary operator guide to IRIS tube placement and interpretation of position.Methods In a single centre, IRIS tubes were prospectively placed in intensive care unit patients. Characteristics of tube placement and visualised anatomy were recorded in each organ to produce a guide.Results Of 45 patients having one tube placement, 3 were aborted due to refusal (n=1) or inability to enter the oesophagus (n=2). Of 43 tubes placed beyond 30 cm, 12 (28%) initially entered the respiratory tract but all were withdrawn before reaching the main carina. We identified anatomical markers for the nasal or oral cavity (97.8%), respiratory tract (100%), oesophagus (97.6%), stomach (100%) and intestine (100%). Organ differentiation was possible in 100%: trachea-oesophagus, oesophagus-stomach and stomach-intestine. Gastric tube position was confirmed by aspiration of fluid with a pH <4.0 and/ or X-ray. Trauma was avoided in 13.6% by identifying that the tube remained in the nasal lumen in the presence of a base of skull fracture (n=3) and in the stomach in the presence of recently bleeding polyps or mucosa (n=3). A systematic guide was produced from records of tube placement and interpretation of anatomical images.Conclusion By permitting real-time confirmation of tube position, direct vision may reduce risk of lung complications. The preliminary operator guide requires validation in larger studies.https://bmjopengastro.bmj.com/content/8/1/e000768.full |
| spellingShingle | Stephen Taylor Zeino Zeino Jules Brown Kaylee Sayer Danielle Milne Integrated real-time imaging system, ‘IRIS’, Kangaroo feeding tube: a guide to placement and image interpretation BMJ Open Gastroenterology |
| title | Integrated real-time imaging system, ‘IRIS’, Kangaroo feeding tube: a guide to placement and image interpretation |
| title_full | Integrated real-time imaging system, ‘IRIS’, Kangaroo feeding tube: a guide to placement and image interpretation |
| title_fullStr | Integrated real-time imaging system, ‘IRIS’, Kangaroo feeding tube: a guide to placement and image interpretation |
| title_full_unstemmed | Integrated real-time imaging system, ‘IRIS’, Kangaroo feeding tube: a guide to placement and image interpretation |
| title_short | Integrated real-time imaging system, ‘IRIS’, Kangaroo feeding tube: a guide to placement and image interpretation |
| title_sort | integrated real time imaging system iris kangaroo feeding tube a guide to placement and image interpretation |
| url | https://bmjopengastro.bmj.com/content/8/1/e000768.full |
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