Safety and effectiveness of the nasal bridle securement device to retain feeding tubes in adult patients in the intensive care unit: An observational study
Bibliographic record
Abstract
BACKGROUND: Nasal bridle securement devices were introduced to our adult intensive care unit (ICU) in October 2016 as an alternative for securing small-bore feeding tubes in patients at higher risk of inadvertent tube dislodgement. METHOD: We assessed high-risk ICU patients from October 2014 to March 2019 to address three objectives. First, we prospectively monitored ICU patients with a nasal bridle for all types of adverse events. Second, we used propensity score methods to create a (1:1) matched historical comparison group (ie, tape group). We then compared the number of inadvertent tube dislodgements and the caloric intake between the tape and nasal bridle groups. RESULTS: In the prospective group (n = 64), there were 20 adverse events, 12 of which were inadvertent tube dislodgements. Forty-eight participants in the nasal bridle group were matched with participants in the historical group. Thirty-five percent (17/48) of patients in the tape group had at least one inadvertent tube dislodgement; in the nasal bridle group, 48% (23/48) had at least one inadvertent tube dislodgement, although this only occurred in 7 of 48 (15%) patients after the nasal bridle had been inserted. The tape group achieved a lower median percentage of total caloric intake received (66.0%) compared with that of the nasal bridle group (86.1%; P = 0.017). CONCLUSIONS: In the subpopulation of ICU patients with a small-bore feeding tube who demonstrate a higher risk of inadvertent tube dislodgement, use of the nasal bridle may be associated with a higher caloric intake, even though it does not completely prevent tube dislodgement.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".