Nonfluoroscopic Feeding Tube Placement: Is It Cheaper Than Traditional Methods?

Nutrition Research Newsletter, March, 2000

In seriously ill patients with functional gastrointestinal tracts, enteral nutrition is a better choice than parenteral means. Feeding via enteral tubes preserves intestinal integrity and prevents bacterial translocation in the gut. Long-term enteral feeds require the placement of a feeding tube into the stomach or upper portion of the small intestine. Tubes can be placed via nonfluoroscopic (NFP) means and are ideally inserted into the distal duodenum or jejunum for decreased risk of reflux and aspiration. Following non fluoroscopic placement of a feeding tube, a radiograph is necessary to evaluate the location of the catheter tip. The number of films needed to determine proper placement and correct problems may be costly and time consuming.

The goal of a recent study was to assess the charge of NFP based on the confirmation of successful placement and compare this cost to that of fluoroscopic placement. In doing so, researchers evaluated the number of films required to determine placement and the total charge of NFP in 257 patients. These numbers were compared to the cost of standard fluoroscopic feeding tube placement.

Thirty-seven percent of tubes were properly inserted via NFP on the first attempt. At the institution where the study took place, the relative cost of a single abdominal film versus fluoroscopic feeding tube placement was 0.54. Additional films were necessary in 162 patients out of the 257 evaluated. Therefore it can be concluded that if proper placement occurred on the first attempt, the relative cost of NFP was close to half that of fluoroscopic placement. However, if multiple radiographs are needed to complete the NFP process, it may be more costly than standard fluoroscopic placement.

M Chen, D. Ott, D. Gelfand, et al., Nonfluoroscopic, Postpyloric Feeding Tube Placement: Number and Cost of Plain Films for Determining Position, Nutrition in Clinical Practice 15: 40-44 (February 2000) [Correspondence: Michael Y. M. Chen, MD, Dept. of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1088.]