Clinical study| Volume 12, ISSUE 4, P435-437, May 2005

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Blind transpyloric nasojejunal versus nasogastric tube intubation in severe head injuries: A preliminary report



      To compare the efficacy of blind transpyloric placement using a specifically designed nasojejunal tube (NJT) versus a standard nasogastric tube (NGT) in severe head injury (SHI).


      This was a randomised trial conducted in a neurosurgical intensive care unit. Fourteen patients were enrolled with a Glasgow Coma Score (GCS) less than 8 (mean 6.8 SEM ± 0.36). Patients were randomised to receive either NJT or NGT.


      There was an 83% (5/6 patients) spontaneous jejunal placement rate of NJT past the ligament of Treitz. The 17% (1/6 patients) jejunal placement failure rate for NJT was due to inappropriate technique. A 100% (8/8 patients) failure of the unweighted NGTs to pass through the pylorus into the jejunum was recorded (P = 0.002).


      In SHI, the specifically designed self-propelling NJT was effective in spontaneous transpyloric placement past the ligament of Treitz within 12 h of introduction into the gastric cavity. The standard un-weighted NGT was ineffective. Additional studies are warranted to determine the clinical efficacy of this self-propelling NJT.


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