• Journal of Veterinary Clinics
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• v.32 no.1
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• pp.28-35
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• 2015

Aim of this study is demonstrate the feasibility of Laparoscopic gastrostomy (LG) tube placement in dogs by comparing with percutaneous endoscopic gastrostomy (PEG) tube placement, based on operative time, complications and gastro-peritoneal adhesion evaluation. Eight intact male beagle dogs were used in this study. Tri-Funnel Replacement Gastrostomy tube (Bard Inc., USA) of 20 Fr was used for LG technique and PEG kit (Ponsky "Pull" PEG Kit$^{(R)}$, Bard Inc., USA) with soft silicone retention dome consisting of a 20 Fr gastrostomy tube was used. Feeding via gastrostomy tube was performed in two weeks, maintenance energy requirement (MER) divided into 3 separate feeding. LG and PEG were evaluated at intraoperative, postoperative and postmortem period. Mean operative time for the PEG group was significantly shorter when compared with the LG group (p < 0.05). Successful maintenance of gastrostomy tube was confirmed in all dogs. Gastric and peritoneal wall adhesions were formed successfully in each group. The mean adhesion length (AL) and width (AW) were significantly larger in LG group compared with in PEG group (p < 0.05). The mean adhesion distance (AD) was not significantly different between two groups (p = 0.182). Consequently, LG is an effective minimally invasive, safe and easy to perform technique for providing enteral nutritional support in dogs.

• Proceedings of the Korea Contents Association Conference
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• 2014.11a
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• pp.189-190
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• 2014

뇌경색, 뇌 신경장애 및 뇌졸중환자 중 급성기 환자는 의식이 없어 연하기능장애로 인한 흡인성 폐렴을 유발하기 때문에 비위관(nasogastric tube)을 삽입하고 영양공급을 한다. 재활훈련 후 회복기에 침상선별검사를 시행하지만 임상적 검사를 통해서는 무증상흡인은 발견할 수 없다. 그래서 연하장애로 비위관을 삽입한 연하재활치료 중인 환자 10명을 대상으로 VFSS를 시행하여 식이재료에 따른 삼킴 정도, 자세에 따른 삼킴을 재활의학과전문의가 평가 후, 흡인이 있거나 삼킴 곤란 등이 있으면 연하재활치료를 시행하여 환자의 상태에 따라 약 30일 ~ 50일후에 재평가를 시행한 후 흡인이 없을 시 비위관을 제거 하였다. 이때 VFSS 영상을 기능적 연하곤란척도를 이용, 분석하여 부여된 점수를 통계 산출 하였는데 비위관 유지군은 $49.79{\pm}9.431$을 보여 흡인의 위험을 나타내며, 비위관 제거군은 $11.20{\pm}1.932$로 흡인의 위험성이 낮아 비위관 제거관련 의미 있게 낮은 점수를 보였다. 두 군의 유의성을 평가하기 위해 Mann-Whitney test를 시행한 결과 p<0.001로 통계적으로 유의하다고 평가하였다. 결론적으로 VFSS는 구강, 인두, 식도의 구조적 이상과 움직임을 가장 효과적으로 평가, 기도흡인여부를 즉시 확인 및 환자에게 적합한 식이나 연하자세를 결정할 수 있어 비위관 제거를 위한 연하평가에 가장 확실한 표준검사로 제안할 수 있다.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.22 no.3
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• pp.318-327
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• 2015

Purpose: The purposes of this study were to compare confidence in practice of intermittent gavage tube feeding and participants' satisfaction by three types of feedback; professor verbal feedback, professor feedback with smartphone video, and peer feedback with smartphone video. In addition, frequently failed items in the intermittent gavage tube feeding procedure were analyzed. Methods: Data were collected from a convenience sample of 78 nursing college students in November 2014. Students were randomly assigned to the control group, experimental group I (smartphone video with professor feedback) or group II (smartphone video with peer feedback). Data were analyzed using descriptive statistics including chi-square test, ANOVA, and Scheffe test with SPSS 21.0. Results: Confidence in practice of intermittent gavage tube feeding and satisfaction with feedback were highest in experimental group I that had professor feedback with smartphone video. For the procedure, the most frequently failed item was giving an explanation to patients about the purpose and the procedure of tube feeding. Conclusion: The results indicate that professor verbal feedback with smartphone video is the most benefit to the nursing students in acquiring core nursing practice skills.

• Journal of Korean Biological Nursing Science
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• v.10 no.2
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• pp.105-112
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• 2008

Purpose: The purpose of this study was to investigate the difference in the incidence of diarrhea among the subjects given hypertonic and isotonic nutrients to the nasogastric tube feeding patients in the a critical care setting. Methods: This study is aquasi-experimental study with a pre & post-test design. The sample size of 40 was calculated based on Cohen's formula (1988). The total of 40 subjects who signed the informed consent were randomly selected and divided evenly into two groups, experimental and control group. Results: There are no significant differences between the two groups in homogeneity test (sex, age, albumin level, the use of antibiotics, antacid, and $H_2$ blocker). However, the frequencies of occurrence in diarrhea according to the density of nutrients formulation indicated a statistical difference at the level of .005 (p=.001): diarrhea occurred in four of 20 (20%) of the experiment group, but 14 (70%) of the control group. Also the onset date of diarrhea in the experiment group is later than that of the control group. Conclusion: The research findings suggest that we should begin with low density nutrients for nasogastric tube feeding, and increase its density gradually to decrease diarrhea incidence in the critical care setting.

• Journal of Korean Biological Nursing Science
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• v.13 no.3
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• pp.204-210
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• 2011

Purpose: The purpose of this study was to provide basic data for the guidelines for cleaning the feeding bags by comparing the level of contamination according to cleaning and disinfection methods when feeding tube of Neurosurgery Intensive Care Unit patients. Methods: This study was a true-experimental study, with 48 cases in total. The feeding bag of 48 patients were randomly assigned to detergent cleaning method or disinfectant decontamination method. The period of the experiment was January to July 2008, and enteral nutrition was given within 30 minutes for 2 hours, 4 times a day at 7AM, noon, 5PM, and 9PM for seven days. Feeding bags were cleaned after each feeding according to the assigned cleaning and disinfection method followed by microbial cultures on 4th and 8th day before the 7AM feeding. Results: After three and seven days of feeding and cleaning, the level of contamination was significantly lower when bags were cleaned with disinfectant than cleaning with detergent and tepid water. Conclusion: In cases where feeding bags are reused, for example, intensive care unit and home care settings, study findings indicate that cleaning bags with disinfectant is an effective way to prevent contamination of bags.

• Journal of Korean Critical Care Nursing
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• v.7 no.1
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• pp.1-10
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• 2014

Purpose: The purpose of this study was developing a nasogastric tube feeding algorithm to prevent aspiration pneumonia. Methods: The algorithm was developed through a methodological design. First, a pilot study was performed to determine the incidence of pneumonia. The second step was development of a preliminary algorithm through a literature review and collection of nurse opinions. The third step was to establish content validity using a panel of 12 experts. The fourth step was revision of the algorithm. Next, 20 intensive care unit nurses applied the revised algorithm for six months to their actual treatment, and the practical feasibility was verified after that. Results: In the patients for whom this algorithm was applied, no cases of pneumonia occurred. The algorithm that was developed by the present author was suitable for clinical application. Conclusion: The effect and practical feasibility of the algorithm was tested with a few patients in this study. The effect of this algorithm should be examined by applying it to more patients on an ongoing basis.

• Journal of the Korean Society of Radiology
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• v.9 no.1
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• pp.1-7
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• 2015

Acute phase patients who are unconscious and are suffering from cerebral infarction, cranial nerve disorders, or cerebral apoplexy are susceptible to aspiration pneumonia due to dysphagia. In these cases, a nasogastric tube is inserted to supply nutrients. Although bedside screening tests are administered during recovery after rehabilitation, clinical examinations may not be able to ascertain asymptomatic aspiration. Therefore, a video fluoroscopy swallowing study (VFSS) was performed in 10 patients with dysphagia after rehabilitation therapy; these patients had nasogastric tubes inserted, and a rehabilitation specialist assessed the degree of swallowing based on the patients' diet and posture. If aspiration or swallowing difficulties were observed, dysphagia rehabilitation therapy was administered. The patients were reassessed approximately 30-50 days after administration of therapy, based on the patients' condition. If aspiration is not observed, the nasogastric tube was removed. A functional dysphagia scale was used to analyze the VFSS images, and the scores were statistically calculated. The mean score of patients with nasogastric tubes was $49.79{\pm}9.431$, thereby indicating aspiration risk, whereas the group without nasogastric tubes showed a mean score of $11.20{\pm}1.932$, which indicated low risk of aspiration. These results demonstrated that a significantly low score was associated with nasogastric tube removal. Mann-Whitney's test was performed to assess the significance of both the groups, and the results were statistically significant with a P value <0.001. In conclusion, VFSS can effectively assess the movements and structural abnormalities in the oral cavity, pharynx, and esophagus. It can also be used to determine the aspiration status and ascertain the appropriate diet or swallowing posture for the patient. Therefore, VFSS can potentially be used as a reliable standard test to assess swallowing in order to determine nasogastric tube removal.

• Korean Journal of Adult Nursing
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• v.26 no.5
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• pp.592-602
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• 2014

Purpose: This study was to provide understanding about the meaning of nasogastric tube feeding experiences by the cerebral stoke patients with dysphagia. Methods: Data were collected through a face to face interview from five cerebral stroke patients who had dysphagia along with a nasogastric tube insertion. The contents of the interviews were analyzed using the hermeneutics phenomenological method developed by van Manen. Results: The experience of having a nasogastric tube was not only limited to physical problems but also was linked to other psychological problems. Many patients reported that they tolerated the nasogastric tube in order to overcome the stroke along with the desire to eventually take food orally. The essential themes associated with the experience of nasogastric tube insertion were: "The loss of pleasure from food", "The loss of human relationship from surrounding table", "Cower and shrink from the different appearance to others" and "Acceptance for life in painful experiences". Conclusion: This study would highlights the importance of not only physical focused care but also psychological and social aspects. Therefore, nurses should consider all factors when providing nursing care to stroke patient with nasogastric tube feeding.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.4
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• pp.645-654
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• 2002

Purposes : This study was conducted to examine nursing effects after using a new method of nasogastric tube feeding with recycled PETE bottle making use of gravity, and to compare with those of bolus method using syringe and pressure. Methods : The data collected from patients with nasogastric tube feeding more than a week at an internal medicine unit of C university hospital located in G-city from January 1st, 1998 through June 30th, 2000. For this nonequivalent control group posttest non-synchronized design, 28 patients were assigned to an experimental group and 35 patients to a control group. The homogeneity of two groups and the dependent variables were tested with use of $x^2-test$ and t-test. Results : The duration of hemostatic use was significantly shorter in the experimental group than control group(t=2.63, p=0.02). Also, the patients with PETE bottle feeding had a lower cost of material(t=3.51, p=0.01) and a lower rate of the time of direct nursing care(t=2.44, p=0.04) than those of control group. But, there was no significant difference between two groups in the length of hospital stay. Conclusion : This results indicates that nasogastric tube feeding with PETE bottle is superior to nasogastric tube feeding with syringe. This findings gave us an evidence to enhance nursing effectiveness in clinical setting.

• Korean Journal of Adult Nursing
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• v.20 no.1
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• pp.44-54
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• 2008

Purpose: The purpose of the study were to examine the nutritional status of severe brain injury adult patients in critical period, and to compare the nutritional states before and after tube feeding. Methods: Data from 19 patients admitted to the SICU in a university hospital due to severe brain injury were analyzed. Nutritional states were measured by anthropometric and blood biochemical indicators. Results: MAC and MAMC were significantly decreased only at 7 days after admission compared with those on the day of admission. TSF was significantly decreased from 7 days to 14 days after admission. Fat rate was significantly decreased from 3 days to 14 days after admission. Hb was significantly decreased only at 3 days after admission. Albumin was significantly decreased from 3 days to 14 days after admission. However, lymphocyte was significantly increased at 14 days after admission. TSF and Albumin became significantly worse even after initiating tube feeding. Conclusions: Nutritional status of severe brain injury patients in SICU became worse after admission whichever indicators were adopted to evaluate nutritional status, anthropometric or blood biochemical indicators, and became worse even after initiating tube feeding.