ESPEN 2021 Late Breaking Abstracts

Topic: Nutritional assessment

Abstract Submission Identifier: ESPEN21-LB-1978

NASAL BRIDLE A USEFUL, SAFETY AND EFFECTIVE TOOL. OUR EXPERIENCE.

R. NIddam^*, ¹, R. Ashbaugh ², M. Bernal ³, J. Alvarez ⁴

¹Endcorinology and Nutrition, ²Nutriton Unit, ³Endocrinology and Nutrition, ⁴Endocirnology and Nutrition, University Hospital Principe de Asturias, Alcala de Henares, Spain

Rationale: Tube feeding (TF) is the most widely used route of enteral nutrition (EN). Accidental and self –withdrawal, especially in agitated patients or patients with endotracheal intubation, is a frequent complication to avoid. The nasal bridle (NB) is an alternative method to containment measures. Our aim was to review the efficacy and safety of BN in a population of patients requiring EN by tube.

Methods: Retrospective observational study in habitual practice conditions. Outcomes measured were demographic and clinical conditions of patients admitted to the hospital (1/2/2020 to 05/13/2021) who required EN by tube, with history of repeated removals and NB placement and related complications. Nurses of the Nutrition Unit placed all the NBs. Statistical analysis was performed using SPSS 26.0.

Results: 51 patients (18 F / 32 M) with a mean age of 73 years (37-96). Their pathologies were Stroke (29.4%); cognitive impairment (21.6%), encephalopathies (7.8%), cancer (15.7%), COVID 19 (9.8%), others (16.6%). Main indications for EN by tube were oropharyngeal dysphagia (54.9%), refusal to ingest (17.6%), orotracheal intubation (7.8%), among others. Only one patient presented pressure ulcers in the nasal septum, not other complications. NB was withdrawn in 7.8% of the cases due to a change in the digestive access (gastrostomy), 21.6% recovered oral route, 9.8% due to ignorance in its management (emergency service and nursing home). We found significant differences between accidental and self-withdrawing tube removals before and after NB placement (2.59 ± 1.512 vs 0.24 ± 0.596; p <0.05).

Conclusion: The nasal bridle is a safe and effective technique for clamping TF, which avoids their pulling out and relevant associated complications. The training of health professionals is essential for its proper use.

References: 1. Bechtold ML,  Nguyen DL, Palmer LB, Kiraly LN, Martindale RG, McClave SA. Nasal bridles for securing nasoenteric tubes: a meta-analysis. Nutr Cli Pract. 2014 October ; 29(5): 667–671

2. Lynch A, Tang C, Jeganathan L, Rockey J. A systematic review of the effectiveness and complications of using nasal bridles to secure nasoenteral feeding tubes. Aust J of Otolaryngol 2018;1-8

Disclosure of Interest: None Declared

Keywords: effective tool, Nasal Bridle , Safety, Tube feeding