Annals of nutrition & metabolism · 2026
Electromagnetic-Guided Nasogastric Tube Insertion by Nurses: A Multicenter Non-Inferiority Study.
СтатьяМногоцентровое исследованиеEquivalence TrialНазвание и аннотация: Перевод в очереди
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Sakuramoto Hideaki, Nakamura Kensuke, Kamogawa Megumi, Note Hideaki, Mori Kazunao, Tatsuno Junko, Yamaguchi Daisuke, Miki Toshifumi, Ikezawa Tomoaki, Hashimoto Hideki, Okamoto Saiko, Tsugu Hitoshi, Shirasaka Masako, Sai Kenichi, Sakamoto Shinya, Yoshida Tomomi, Kajiwara Saori
Аннотация
UNLABELLED: <p>Introduction: Nasogastric tube feeding is essential for critically ill patients, yet blind insertion risks misplacement and related complications. Electromagnetic guidance enables real-time tracking, potentially enhancing safety and efficiency. This study aimed to compare the safety and effectiveness of nurse-led electromagnetic-guided nasogastric tube insertion with those of physician-performed blind insertion in critically ill patients.
METHODS: This multicenter prospective non-inferiority trial was conducted in seven Japanese intensive care units (July 2023-February 2025). Physicians performed blind insertions in the initial phase, followed by nurse training and electromagnetic-guided insertions using the CORTRAK system. The primary outcome was successful gastric placement without special techniques. Secondary outcomes included insertion time, attempts, complications, and tube position.
RESULTS: A total of 283 patients were analyzed (141 electromagnetic-guided, 142 blind). Success rates were similar (63.1% vs. 65.5%; difference -2.4%, 95% confidence interval: -13.5 to 8.8), confirming non-inferiority (Farrington-Manning p = 0.001). Electromagnetic-guided insertions required fewer reinsertions (median 0 vs. 1; p = 0.049) and less time (3.3 vs. 4.5 min; p = 0.03) in unadjusted analyses. No tracheobronchial misplacements occurred (blind: 1.4%). Complication rates were low and comparable.
CONCLUSION: Nurse-led electromagnetic-guided nasogastric tube insertion appears to be a safe, effective alternative to physician blind insertion, with comparable success and potential efficiency advantages. </p>.
METHODS: This multicenter prospective non-inferiority trial was conducted in seven Japanese intensive care units (July 2023-February 2025). Physicians performed blind insertions in the initial phase, followed by nurse training and electromagnetic-guided insertions using the CORTRAK system. The primary outcome was successful gastric placement without special techniques. Secondary outcomes included insertion time, attempts, complications, and tube position.
RESULTS: A total of 283 patients were analyzed (141 electromagnetic-guided, 142 blind). Success rates were similar (63.1% vs. 65.5%; difference -2.4%, 95% confidence interval: -13.5 to 8.8), confirming non-inferiority (Farrington-Manning p = 0.001). Electromagnetic-guided insertions required fewer reinsertions (median 0 vs. 1; p = 0.049) and less time (3.3 vs. 4.5 min; p = 0.03) in unadjusted analyses. No tracheobronchial misplacements occurred (blind: 1.4%). Complication rates were low and comparable.
CONCLUSION: Nurse-led electromagnetic-guided nasogastric tube insertion appears to be a safe, effective alternative to physician blind insertion, with comparable success and potential efficiency advantages. </p>.