{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T13:50:01Z","timestamp":1784123401816,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T00:00:00Z","timestamp":1679356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nut in Clin Prac"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The Cortrak Enteral Access System (CEAS) was previously approved by the United States Food and Drug Administration (FDA) to be used in lieu of radiographic confirmation imaging for feeding tubes placed by trained clinicians. Following an institutional protocol change in 2016, our registered dietitians had the option to forgo radiographic confirmation imaging for tubes placed using the CEAS. Our research aimed to determine the difference in the number of radiographic confirmation images for feeding tubes placed using the CEAS between preprotocol and postprotocol environments and the associated cost avoidance after the institutional policy change.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed data from 506 tube placements (<jats:italic>n<\/jats:italic>\u2009=\u2009253 per protocol environment) in adult patients with diverse diagnoses admitted to various in\u2010patient care units.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was a significant reduction in the mean number of radiographic images per tube placement (preprotocol\u2009=\u20091.10 [95% CI, 1.05\u20131.15]; postprotocol\u2009=\u20090.36 [95% CI, 0.30\u20130.41]; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), leading to a cost avoidance of $67,282.80 for the 253 tube placements and a potential cost avoidance of $279,236 over the 5\u2010year postprotocol environment. Additionally, the mean time to initiation of enteral nutrition was significantly reduced by 2.65\u2009h in the postprotocol environment (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings suggest that using the CEAS can reduce the number of radiographic images, provide cost avoidance, and improve nutrition outcomes. However, updated 2022 FDA regulatory changes to the use of the CEAS for tube confirmation lead to an uncertain future for this practice because of safety concerns.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ncp.10979","type":"journal-article","created":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T05:07:15Z","timestamp":1679375235000},"page":"1324-1333","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Small\u2010bore feeding tubes placed with an electromagnetic imaging device leads to cost avoidance and decreased time to initiation of enteral nutrition"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1295-0199","authenticated-orcid":false,"given":"Michaelann","family":"Hahn","sequence":"first","affiliation":[{"name":"Baylor Simmons Transplant Institute Baylor University Medical Center Dallas Texas USA"},{"name":"Departement of Clinical and Preventive Nutrition Sciences, Rutgers School of Health Professions Rutgers University Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Byham\u2010Gray","sequence":"additional","affiliation":[{"name":"Departement of Clinical and Preventive Nutrition Sciences, Rutgers School of Health Professions Rutgers University Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamed","family":"Samavat","sequence":"additional","affiliation":[{"name":"Departement of Clinical and Preventive Nutrition Sciences, Rutgers School of Health Professions Rutgers University Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Roberts","sequence":"additional","affiliation":[{"name":"Nutrition and Dietetics Education Program Keiser University  Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Brody","sequence":"additional","affiliation":[{"name":"Departement of Clinical and Preventive Nutrition Sciences, Rutgers School of Health Professions Rutgers University Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607115621863"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-016-1298-1"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2012.12.010"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v19.i6.917"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2011.1801"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2012.27.3.261"},{"issue":"1","key":"e_1_2_8_8_1","first-page":"7","article-title":"Influence of different routes of nutrition on respiratory muscle strength and outcome of elderly patients in respiratory intensive care unit","volume":"19","author":"Chen F","year":"2011","journal-title":"Chin J Clin Nutr"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607116673053"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.4037\/ccn2016141"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ncp.10671"},{"key":"e_1_2_8_12_1","unstructured":"Department of Health and Human Services; U.S. Food & Drug Administration.Indications for use: K191340. 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Version 27.0.IBM Corp;2020."},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/jpen.1015"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2013755"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-277X.2009.01010.x"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-015-9607-4"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2015493"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2014954"},{"key":"e_1_2_8_28_1","unstructured":"U.S. Food & Drug Administration.Avanos Medical recalls Cortrak*2 Enteral Access System for risk of misplaced enteral tubes could cause patient harm. 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