Nasal bridles for securing nasoenteric tubes: a meta-analysis

Abstract

Background: Nasoenteric feeding tubes may easily become dislodged due to patient mental status, transfers, or positional changes. Nasal bridles were introduced to provide a better, more reliable system to secure these tubes. This meta-analysis was performed to evaluate the effectiveness of nasal bridles compared with the traditional method of adhesive tape alone in securing enteral feeding tubes.

Materials and methods: Multiple databases were searched (October 2013). All studies that evaluated the use of nasal bridles in adult patients were included in the analysis. Meta-analysis for the outcomes from use of a nasal bridle vs the more traditional method of adhesive tape alone for securing nasoenteric tubes was analyzed by calculating pooled estimates of dislodgement, skin complications, and sinusitis. Statistical analysis was performed using RevMan 5.1.

Results: Six studies (n = 594) met the inclusion criteria. Use of a nasal bridle for securing enteral tubes resulted in a statistically significant reduction in tube dislodgement compared with traditional adhesive tape alone (odds ratio [OR], 0.16; 95% confidence interval [CI], 0.10–0.27; P < .01). The use of nasal bridles was associated with a higher rate of skin complications compared with traditional adhesive tape (OR, 4.27; 95% CI, 1.79–10.23; P < .01). Incidence of sinusitis was no different between the 2 groups (OR, 0.26; 95% CI, 0.03–2.28; P = .22).

Conclusion: Nasal bridles appear to be more effective at securing nasoenteric tubes and preventing dislodgement than traditional use of tape alone.

Figures

Figure 1

Article search algorithm in October 2013.

Figure 2

Forest plot demonstrating comparison of nasal bridle vs traditional adhesive tape in securing nasoenteric tubes for tube dislodgement. CI, confidence interval; M–H, Mantel-Haenszel.

Figure 3

Forest plot demonstrating comparison of nasal bridle vs traditional adhesive tape in securing nasoenteric tubes for skin complications. CI, confidence interval; M–H, Mantel-Haenszel.

Figure 4

Forest plot demonstrating comparison of nasal bridle vs traditional adhesive tape in securing nasoenteric tubes for sinusitis. CI, confidence interval; M–H, Mantel-Haenszel.