Spontaneous transpyloric migrationof a ballooned nasojejunal tube: A randomized controlled trial

• Published in: JPEN. Journal of parenteral and enteral nutrition Vol. 24; no. 4; p. 240
• Main Authors: Cohen, Leon D, Alexander, David J, Catto, Jim, Mannion, R
• Format: Journal Article
• Language: English
• Published: Silver Spring American Society for Parenteral and Enteral Nutrition 01.07.2000
• ISSN: 0148-6071; 1941-2444

BACKGROUND: Spontaneous transpyloric migration of a simple nasojejunal tube (NJT) can be expected in only one-third of insertions. Guidance of the tube by radiologic or endoscopic maneuvers is usually required. We believed that locating a 5-mL balloon near the tip of an NJT on which natural peristalsis could act would improve the rate of spontaneous transpyloric migration and facilitate small bowel propagation. METHODS: Thirty healthy volunteers were randomly assigned to have an inflated or noninflated, ballooned NJT fashioned from a modified 9F Hickman line catheter inserted. The pH of aspirates was measured hourly and the final location of the tube assessed by gastrografin contrast abdominal x-ray (AXR) at the end of 6 hours, at which time the tube was removed. RESULTS: After 6 hours, spontaneous transpyloric migration occurred in 86.6% of the ballooned and 66.6% of the nonballooned tubes. The final disposition of the ballooned tubes was: stomach, 2 (13.3%); duodenum, 1 (6.7%); and small bowel, 12 (80%). The final disposition of the nonballooned tubes was: stomach, 5 (33%), NS; duodenum, 9 (60%), p < .05; and small bowel, 1 (6.7%), p < .05. CONCLUSIONS: Ballooned NJT have a higher rate of spontaneous transpyloric migration and are significantly more likely to achieve an optimal small bowel location.