• Xuejin Gao, Li Zhang, Jie Zhao, Feng Tian, Haifeng Sun, Peng Wang, Jiwei Wang, Zhiming Wang, and Xinying Wang.
• Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China.
• J Crit Care. 2018 Dec 1; 48: 216-221.

PurposeWe aimed to compare the effectiveness of EM-guided and endoscopic nasoenteral feeding tube placement among critically ill patients.Materials And MethodsWe performed a single-center, randomized controlled trial among 161 adult patients admitted to intensive care units (ICUs) requiring nasoenteral feeding. Patients were randomly assigned to EM-guided or endoscopic nasoenteral feeding tube placement (1:1). The primary end point was the total success rate of correct jejunal placement.ResultsThis was achieved in 74/81 and 76/80 patients who underwent EM-guided and endoscopic jejunal tube placements, respectively (91.4% vs. 95%; relative risk, 0.556; [CI], 0.156-1.980; P = 0.360). The EM-guided group had more placement attempts, longer placement time, and shorter inserted nasal intestinal tube length. However, they had shorter total placement procedure duration and physician's order-tube placement and order-start of feeding intervals. The EM-guided group had higher discomfort level and recommendation scores and lesser patient costs. This trial is registered at Chinese Clinical Trials Registry (ChiCTR-IOR-17011737).ConclusionBedside EM-guided placement is as fast, safe, and successful as endoscopic placement and may be considered the preferred technique in critically ill patients.Copyright © 2018. Published by Elsevier Inc.

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