• Ichiro Osawa, Norihiko Tsuboi, Hisataka Nozawa, Nao Nishimura, and Satoshi Nakagawa.
• All authors: Department of Critical Care and Anesthesia, National Center for Child Health and Development, Tokyo, Japan.
• Pediatr Crit Care Me. 2021 May 1; 22 (5): e324-e328.

ObjectivesVarious methods to insert postpyloric feeding tubes at the bedside have been reported, but the optimal method remains controversial. The objective of this study was to evaluate the effect of ultrasound-guided postpyloric feeding tube placement in critically ill children.DesignSingle-center retrospective observational study.SettingPICU of tertiary children's hospital.PatientsChildren under the age of 16 who underwent postpyloric feeding tube placement in our PICU between September 2017 and August 2019.InterventionsNone.Measurements And Main ResultsA total of 115 patients were included in this study: 30 patients underwent ultrasound-guided postpyloric feeding tube placement and 85 patients underwent blind postpyloric feeding tube placement; the insertion attempts were 32 and 93, respectively. There were no significant differences in patient demographics between the ultrasound-guided group and the blind group. The first-pass success rate of the ultrasound-guided group was higher than that of the blind group (94% [30/32] vs 57% [53/93]; p < 0.001). The median insertion time in the ultrasound-guided group with successful postpyloric feeding tube insertion was 18 minutes (interquartile range, 15-25; range, 8-45; n = 21). There were no complications or adverse events during the placement.ConclusionsIn this single-center study, ultrasound-guided postpyloric feeding tube placement was feasible and a significantly high first-pass success rate was observed for critically ill children. Additional investigation with a larger pool of operators and randomized controlled patient assignment is required.Copyright © 2021 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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