Efficacy of ultrasound-guided nasointestinal tube placement technique based on the "R-S-A" 3-point positioning in critically ill patients

Objective To evaluate the precision and effectiveness of ultrasound-guided visualization for nasojejunal tube placement with the "R(right reclining)-S(shoulder)-A(abdominal)" 3-point positioning for critically ill patients. Methods A retrospective analysis was conducted on all critically ill patients who underwent nasojejunal tube placement in Department of Critical Medicine of a tertiary hospital in Chongqing from April 2022 to August 2023. According to the position of the catheter, they were divided into a control group and an observation group. The control group received ultrasound-guided nasojejunal tube insertion, while the observation group used the "R-S-A" 3-point positioning (the patient were placed in a right lateral position, the nurse stood at the right shoulder of the patient, and the ultrasound operator stood on the right side of the abdomen in the operating direction) for ultrasound-guided nasojejunal tube insertion. And, the control group had no specific requirements for positioning during the procedure. After propensity matching, the time and success rate of catheter insertion and incidence of complications were compared between the 2 groups. Results The time of catheter insertion was significantly shorter (36.2±10.3 vs 42.3±8.3 min), and the success rate of insertion was obviously higher (95.2% vs 66.7%) in the observation group when compared with the control group (P<0.05). The incidence of complication was 9.5% in the observation group, and 28.6% in the control group, but there was no statistical difference between the 2 groups. Conclusion Ultrasound-guided nasojejunal tube placement based on "R-S-A" 3-point positioning has high precision and strong effectiveness in critically ill patients, which can shorten the time and improve the success rate of catheter insertion.