Improving enteral nutrition in patients requiring neurological intensive care unit care: A retrospective study on a novel bedside nasointestinal tube placement technique

BACKGROUND: This study aimed to develop and assess a bedside nasojejunal tube placement technique designed for resource-limited settings to address the specific challenges of enteral nutrition (EN) delivery in neurocritical care patients, particularly those at high risk of reflux and aspiration. The technique sought to overcome the drawbacks of conventional placement methods that depend on specialized equipment or are time-consuming, thereby improving accessibility in constrained healthcare environments. METHODS: A simplified nasojejunal tube placement method not requiring specialized equipment was implemented. Fifty-six neurocritically ill patients were enrolled, and outcomes-including success rate, placement time, operator variability, and adverse events-were evaluated. Minor adverse events were managed using standard care protocols. RESULTS: The technique achieved a 91.07% success rate, with a mean placement time of 21.27 min (range, 10-30 min). Comparative analysis showed minimal interoperator variability, with no significant differences in placement time (P = 0.667) or number of attempts (P = 0.644), confirming the method's reproducibility and ease of learning. No severe complications occurred, and minor events such as nasal mucosal bleeding were effectively managed. General adverse events were observed in 32.14% of cases with no long-term complications. CONCLUSION: The bedside nasojejunal tube placement technique is a safe, practical, and cost-effective approach for optimizing EN delivery in neurocritical care patients. By simplifying the procedure and eliminating the need for specialized equipment, this method enhances clinical efficiency and feasibility in resource-limited settings. Its high success rate and adaptability support its potential for broader clinical implementation.