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Nutrition in Clinical Practice
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Clinical Research

The Routine Bridling of Nasojejunal Tubes Is a Safe and Effective Method of Reducing Dislodgement in the Intensive Care Unit

Christopher W. Seder, MD
Randy Janczyk, MD

From Department of Surgery, William Beaumont Hospital, Royal Oak, Michigan.

Correspondence: Address correspondence to Christopher W. Seder, MD, 3601 W. 13 Mile Road, Department of Surgery, William Beaumont Hospital, Royal Oak, MI 48073; e-mail: cwseder{at}yahoo.com.

Purpose: To determine if the routine bridling of nasoenteric feeding tubes in the intensive care unit is a low-morbidity, cost-effective method of decreasing tube dislodgement. Methods: Data were prospectively collected from 62 consecutive bridled patients and compared with that from 172 consecutive unbridled patients for differences in tube dislodgement, nasal ulceration, and estimated cost. Results: Bridled patients demonstrated significantly less tube dislodgement (6.5% vs 32.6%, P < .0001). Bridling resulted in 4 cases of nasal ulceration per 800 tube feeding days, all of which were associated with red rubber catheter bridles. Conversion to 1/8-in umbilical tape bridles eliminated ulceration and further reduced dislodgement from 10% to 4.8%. Implementation of bridling saved an estimated $4038 over 3 months. Conclusions: Nasal bridling is a simple, cost-effective practice that may reduce the rate of nasoenteric tube dislodgement. The use of 1/8-in umbilical tape may be more effective and safer than 8-Fr red rubber catheters for this purpose.

Key Words: enteral nutrition • tube feeding • intensive care units

Nutrition in Clinical Practice, Vol. 23, No. 6, 651-654 (2008)
DOI: 10.1177/0884533608326139
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