Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2024; 12(27): 6124-6131
Published online Sep 26, 2024. doi: 10.12998/wjcc.v12.i27.6124
Bedside visual nasojejunal tube placement in prone-ventilated patients facilitated by real-time imaging: A case report
Yi-Hao Kang, Yu-Tian Wu, Yue-Qun Chen
Yi-Hao Kang, Department of Intensive Care Unit, Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, Lishui 323000, Zhejiang Province, China
Yu-Tian Wu, Department of Intensive Care Unit, No. 971st Hospital of the People’s Liberation Army Navy, Qingdao 266000, Shandong Province, China
Yue-Qun Chen, Department of Intensive Care Unit, Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China
Author contributions: Kang YH, Wu YT, and Chen YQ designed the research study; Kang YH and Wu YT performed the research; Chen YQ contributed new reagents and analytic tools; Kang YH, Wu YT, and Chen YQ analyzed the data and wrote the manuscript; All authors have read and approved the final manuscript.
Supported by Zhejiang Basic Public Welfare Research Project, China, No. LGF22H180033; and Medical and Health Science and Technology Project of Zhejiang Province, China, No. 2024KY1842.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment. Written informed consent was obtained from the patient, or their legal guardian, for publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016) and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: Https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yue-Qun Chen, MD, Professor, Department of Intensive Care Unit, Fifth Affiliated Hospital of Wenzhou Medical University, No. 289 Kuocang Road, Liandu District, Lishui 323000, Zhejiang Province, China. 13587169583@163.com
Received: May 8, 2024
Revised: June 14, 2024
Accepted: July 10, 2024
Published online: September 26, 2024
Processing time: 82 Days and 2.8 Hours
Abstract
BACKGROUND

This case report describes an innovative approach to nasojejunal (NJ) tube placement in a 55-year-old male COVID-19 patient requiring prone ventilation. The visual-guided method with real-time imaging significantly reduced procedural time and eliminated the need for immediate X-ray confirmation, enhancing procedural efficiency and safety.

CASE SUMMARY

A 55-year-old male with severe COVID-19 and acute respiratory distress syndrome (ARDS) was admitted to the intensive care unit. His medical history included controlled hypertension and type 2 diabetes. Using visual guidance and real-time imaging, NJ tube was placed at the bedside, reducing the procedure time to ~11 min. This technique enabled immediate enteral feeding at 25 mL/h, minimizing healthcare personnel exposure. The visual method, supported by diagnostic evaluations such as radiography and ultrasound, allowed for real-time adjustments, ensuring accurate placement and reducing risks. The patient showed improved metabolic stability and respiratory parameters, with a PaO2/FiO2 ratio increase from 120 mmHg to 200 mmHg within days.

CONCLUSION

Visual-guided NJ tube placement enhances procedural efficiency and patient safety in critical care settings.

Keywords: Nasojejunal tube placement, Prone ventilation, Real-time imaging, COVID-19, Healthcare personnel safety, Enteral feeding, Case report

Core tip: A novel bedside visual nasojejunal tube placement technique was used in a patient with prone-ventilated COVID-19, utilizing real-time imaging to ensure accurate placement. This approach reduced procedural time, enhanced safety by minimizing the need for X-ray confirmation, and improved patient outcomes through timely enteral nutrition.