Bedside naso-jejunal placement is more difficult, but successful in patients with COVID-19 in critical care: A retrospective service evaluation of a dietitian-led service

Mary E Phillips; Jessica Zekavica; Rajesh Kumar; Rajiv Lahiri; Justin Kirk-Bayley; Amish Patel; Adam E Frampton

doi:10.1177/17511437231153045

Bedside naso-jejunal placement is more difficult, but successful in patients with COVID-19 in critical care: A retrospective service evaluation of a dietitian-led service

J Intensive Care Soc. 2023 Nov;24(4):435-437. doi: 10.1177/17511437231153045. Epub 2023 Feb 11.

Authors

Mary E Phillips^{1

2}, Jessica Zekavica^{1

3}, Rajesh Kumar², Rajiv Lahiri², Justin Kirk-Bayley³, Amish Patel³, Adam E Frampton²

Affiliations

¹ Department of Nutrition and Dietetics, Royal Surrey County Hospital, Guildford, UK.
² Hepato-Pancreatico-Biliary Surgical Unit, Royal Surrey County Hospital, Guildford, UK.
³ Intensive Care Department, Royal Surrey County Hospital, Egerton Road, Guildford, UK.

Abstract

The COVID-19 pandemic presented clinical and logistical challenges in the delivery of adequate nutrition in the critical care setting. The use of neuromuscular-blocking drugs, presence of maxilla-facial oedema, strict infection control procedures, and patients placed in a prone position complicated feeding tube placement. We audited the outcomes of dietitian-led naso-jejunal tube (NJT) insertions using the IRIS^® (Kangaroo, USA) device, before and during the COVID-19 pandemic. NJT placement was successful in 78% of all cases (n = 50), and 87% of COVID-19 cases. Anaesthetic support was only required in COVID-19 patients (53%). NJT placement using IRIS was more difficult but achievable in patients with COVID-19.

Keywords: Naso-jejunal feeding tube; bedside placement; dietitian; enteral feeding.