Abstract：
BACKGROUND: Nasal bridle securement devices were introduced to our adult intensive care unit (ICU) in October 2016 as an alternative for securing small-bore feeding tubes in patients at higher risk of inadvertent tube dislodgement.
METHODS: We assessed high-risk ICU patients from October 2014 to March 2019 to address three objectives. First, we prospectively monitored ICU patients with a nasal bridle for all types of adverse events. Second, we used propensity score methods to create a (1:1) matched historical comparison group (ie, tape group). We then compared the number of inadvertent tube dislodgements and the caloric intake between the tape and nasal bridle groups.
RESULTS: In the prospective group (n = 64), there were 20 adverse events, 12 of which were inadvertent tube dislodgements. Forty-eight participants in the nasal bridle group were matched with participants in the historical group. Thirty-five percent (17/48) of patients in the tape group had at least one inadvertent tube dislodgement; in the nasal bridle group, 48% (23/48) had at least one inadvertent tube dislodgement, although this only occurred in 7 of 48 (15%) patients after the nasal bridle had been inserted. The tape group achieved a lower median percentage of total caloric intake received (66.0%) compared with that of the nasal bridle group (86.1%; P = 0.017).
CONCLUSIONS: In the subpopulation of ICU patients with a small-bore feeding tube who demonstrate a higher risk of inadvertent tube dislodgement, use of the nasal bridle may be associated with a higher caloric intake, even though it does not completely prevent tube dislodgement.
METHODS: We assessed high-risk ICU patients from October 2014 to March 2019 to address three objectives. First, we prospectively monitored ICU patients with a nasal bridle for all types of adverse events. Second, we used propensity score methods to create a (1:1) matched historical comparison group (ie, tape group). We then compared the number of inadvertent tube dislodgements and the caloric intake between the tape and nasal bridle groups.
RESULTS: In the prospective group (n = 64), there were 20 adverse events, 12 of which were inadvertent tube dislodgements. Forty-eight participants in the nasal bridle group were matched with participants in the historical group. Thirty-five percent (17/48) of patients in the tape group had at least one inadvertent tube dislodgement; in the nasal bridle group, 48% (23/48) had at least one inadvertent tube dislodgement, although this only occurred in 7 of 48 (15%) patients after the nasal bridle had been inserted. The tape group achieved a lower median percentage of total caloric intake received (66.0%) compared with that of the nasal bridle group (86.1%; P = 0.017).
CONCLUSIONS: In the subpopulation of ICU patients with a small-bore feeding tube who demonstrate a higher risk of inadvertent tube dislodgement, use of the nasal bridle may be associated with a higher caloric intake, even though it does not completely prevent tube dislodgement.
摘要：
背景：2016年10月，我们的成人重症监护病房（ICU）引入了鼻绳固定装置，作为一种替代方法，用于在意外导管移位风险较高的患者中固定小口径饲管。
方法：我们评估了2014年10月至2019年3月的ICU高危患者，以解决三个目标。首先,我们前瞻性地监测了ICU有鼻绳的患者的所有类型的不良事件.第二,我们使用倾向评分方法创建一个(1：1)匹配的历史比较组(即，磁带组)。然后，我们比较了胶带组和鼻绳组之间的意外导管移位次数和热量摄入。
结果：在前瞻性组中（n=64），有20个不良事件，其中12例是无意的导管移位。鼻绳组的48名参与者与历史组的参与者进行了匹配。胶带组中有35％（17/48）的患者至少有一次意外的导管移位；在鼻绳组中，48%(23/48)至少有一次意外的导管移位，尽管这只发生在插入鼻绳后的48例患者中的7例（15％）。与鼻绳组（86.1％；P=0.017）相比，胶带组获得的总热量摄入的中位数百分比（66.0％）较低。
结论：在使用小口径饲管的ICU患者亚群中，有较高的意外脱管风险，使用鼻绳可能与更高的热量摄入有关，即使它不能完全防止管移位。
方法：我们评估了2014年10月至2019年3月的ICU高危患者，以解决三个目标。首先,我们前瞻性地监测了ICU有鼻绳的患者的所有类型的不良事件.第二,我们使用倾向评分方法创建一个(1：1)匹配的历史比较组(即，磁带组)。然后，我们比较了胶带组和鼻绳组之间的意外导管移位次数和热量摄入。
结果：在前瞻性组中（n=64），有20个不良事件，其中12例是无意的导管移位。鼻绳组的48名参与者与历史组的参与者进行了匹配。胶带组中有35％（17/48）的患者至少有一次意外的导管移位；在鼻绳组中，48%(23/48)至少有一次意外的导管移位，尽管这只发生在插入鼻绳后的48例患者中的7例（15％）。与鼻绳组（86.1％；P=0.017）相比，胶带组获得的总热量摄入的中位数百分比（66.0％）较低。
结论：在使用小口径饲管的ICU患者亚群中，有较高的意外脱管风险，使用鼻绳可能与更高的热量摄入有关，即使它不能完全防止管移位。
