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Placement of Nasoenteral Feeding Tubes Using Magnetic Guidance: Retesting a New Technique

Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System and Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas (B.O., M.F., D.H.S.)
Abbott Laboratories, Ross Products Division, Columbus, Ohio (J.H.)

Address reprint requests to: Dennis H. Sullivan, MD, Geriatric Research Education and Clinical Center (182/LR), Central Arkansas Veterans Healthcare System, 4300 West 7^th Street, Little Rock, AR 72205. E-mail: SullivanDennisH{at}exchange.uams.edu.

Objective: To study a new technique of intubating the small bowel using a newly developed nasoenteral feeding tube fitted with a magnet in its tip and guided for placement with an external magnet.

Methods: The study was performed in medical and surgical wards of a university-affiliated Department of Veterans Affairs hospital on 42 patients referred by their attending physicians for tube placement. The newly designed feeding tube was inserted per nares into the stomach using traditional technique. As the tube was advanced, movement of the hand-held steering magnet was designed to guide the tip of the magnetic nasoenteral tube along the lesser curvature of the stomach, through the pyloric sphincter, and into the duodenum. Portable abdominal radiography confirmed the anatomic location of the tube tip.

Results: Fifty-one intubations were performed on 42 subjects. In 45 intubations (88%), tubes passed into the duodenum. Twenty-seven (53%) met criteria for optimal placement in the second portion of the duodenum or distally. Six of 11 tubes (55%) that were not optimally placed were advanced to the distal duodenum on repositioning. Median procedure time for the initial intubations was 30 minutes (interquartile range 15–40). Median procedure time for last 10 intubations improved to 13 minutes (interquartile range 5–20). No complications were related to the procedure.

Conclusions: Enteral feeding tube placement using external magnetic guidance is a promising, novel technique which is deserving of further study.

Key words: enteral nutrition, intubation, gastrointestinal, nutritional support, duodenum

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