Banca de DEFESA: CINTIA GALVÃO QUEIROZ

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : CINTIA GALVÃO QUEIROZ
DATE: 15/12/2023
TIME: 14:30
LOCAL: Departamento de Enfermagem - DENF
TITLE:

Efficacy of non-instrumental techniques for feeding tube insertion in critically ill patients: randomized clinical trial.

KEY WORDS:

Gastrointestinal intubation. Nasogastric Intubation. Enteral nutrition. Intensive care. Healthcare. Quality of Health Care. Patient Safety. Controlled Clinical Trial. Nursing.

PAGES: 80
BIG AREA: Ciências da Saúde
AREA: Enfermagem
SUMMARY:

The insertion of the nasoenteral tube, despite being a frequent procedure, is invasive and traditionally inserted ‘‘blindly’’, with the patient’s head in the neutral position and without instrumental assistance or external laryngeal manipulation. This procedure sometimes becomes difficult and traumatic, presenting greater complexity in patients in coma (physiological or induced) and intubated, becoming a challenge in the face of anatomical obstacles. Therefore, its insertion presents no risks, adverse events may occur during this procedure and compromise patient safety. To this end, the objective was to compare the effectiveness of two non-instrumental methods of nasojejunal feeding tube insertion in patients in coma (physiological or induced) and intubated. This is a prospective, planned and controlled clinical trial, carried out in the Intensive Care Unit of Hospital Dr. José Pedro Bezerra, where adult patients in a physiological or induced coma and intubated were selected. They were randomly distributed into two groups: those who had the probe inserted conventionally, with the head in the neutral position (Control Group) and the group with the head positioned laterally to the right (Intervention Group). In both cases, the patients were in a supine position, without a pillow, in a semi-Fowler position and there were no chin, jaw or larynx maneuvers. The following calculations were recorded: (1) Success rate of the selected technique in the first attempt, second attempt and total; (2) Time required for the first successful attempt and the sum of all attempts; (3) Complications during insertion, including probe kinking, twisting, knotting, mucosal bleeding and insertion into the trachea; (4) Mandatory patient signals. The project was assessed by the Research Ethics Committee of the Federal University of Rio Grande do Norte, where it received a favorable opinion and was registered on the Brazilian Clinical Trials Registry platform (RBR-8cktds4). 32 patients were distributed according to randomization and allocated as follows: 16 (50%) in the CG and 16 (50%) in the IG. There was no significant difference in terms of age, sex, weight, height and body mass index between the groups. The overall success rate was 75%. Success in the first attempt to insert in intubated patients was 87.50% in the IG and 62.50% when compared to the CG. The time required for successful insertion
was shorter in the IG (53.31 ± 17.50) compared to the CG (84.38 ± 29.81), showing a statistical difference in the insertion time between the groups (P < 0.001). Complications were higher in the CG (31.25%) compared to the IG (6.25%). There were no cases of serious complications. Furthermore, when evaluating the average hemodynamic parameters (systolic and diastolic blood pressure, heart rate, pulse and oxygen saturation), there was no significant difference between the two groups, before and after probe insertion. It is concluded that the simple neck lateralization maneuver, as a stand-alone maneuver, results in faster and more successful insertion times, with low complication rates, avoiding unnecessary manipulations of the thyroid, larynx and airway instrumentation.

COMMITTEE MEMBERS:
Externo ao Programa - 2140865 - GABRIELA DE SOUSA MARTINS MELO DE ARAUJO - UFRNExterna à Instituição - ISABEL KAROLYNE FERNANDES COSTA - EBSERH
Externa ao Programa - 2553720 - KATIA REGINA BARROS RIBEIRO - UFRNExterna à Instituição - LAYS PINHEIRO DE MEDEIROS - EBSERH
Presidente - 3578073 - RODRIGO ASSIS NEVES DANTAS