Safety and efficacy of endoscopy-guided nasojejunal feeding tube placement in ICU post-COVID-19 patients: a retrospective study.

BACKGROUND

Post-COVID-19 complications have emerged as one global health event, and early nutritional support via nasojejunal feeding tubes plays a critical role in critically ill patients. The unique systemic inflammatory milieu and altered ICU care protocols of the post-COVID-19 may have influenced insertion success rates and patient outcomes.

OBJECTIVES

In a retrospective cohort of 244 adult post‑COVID‑19 ICU patients, we evaluated the safety and performance of endoscopy-guided nasoenteric feeding tube (ENFT) versus blind bedside nasoenteric feeding tube (BNFT) by assessing insertion success rate, procedure duration, and clinical outcomes.

DESIGN

A retrospective cohort study.

DATA PERIOD: Data were collected from ICU admission until ICU discharge.

SETTING

Intensive Care Unit (ICU) of the Fifth Affiliated Hospital of Wenzhou Medical University.

PATIENTS AND

METHODS

A total of 244 post-COVID-19 ICU patients were divided into the ENFT group (n = 81) and the BNFT group (n = 163) following over six months of infection. Primary outcomes include insertion success rate, insertion time, dislodgement, gastrointestinal bleeding, perforation risks, and pain or discomfort. Secondary outcomes assess heart rates, breathing rates, gastrointestinal complications, ICU stay duration, ventilator-associated events, respiratory distress, inflammatory markers, nutritional status, and mortality, lung function impairment and mental health.

RESULTS

The ENFT group demonstrated a significantly higher insertion success rate (p < 0.001), shorter insertion time (p < 0.001), fewer cases of tube dislodgement (p < 0.001), reduced pain or discomfort (p = 0.010), and a shorter ICU stay (p < 0.001). ENFT placement yielded better respiratory outcomes-higher SpO₂, FiO₂ and PaO₂/FiO₂ (all p < 0.001)-lower inflammation for CRP and IL-6 (all p < 0.001), and improved nutritional and psychological metrics (albumin: p < 0.001; depression: p < 0.001).

CONCLUSIONS

ENFT placement significantly improves procedural efficiency, enhances safety in ICU post-COVID-19 patients by reducing complications.