IRIS-guided visualization enhances postpyloric feeding-tube placement in critically ill patients

Visualization technology guided by the integrated real-time imaging system (IRIS) results in a significant decrease in procedural duration and improvements in the first-attempt success rate for postpyloric feeding-tube placement in critically ill patients, according to a study.

Forty-six critically ill patients requiring enteral nutrition due to dysphagia or high aspiration risk were included in this prospective randomized controlled trial. They were randomly allocated to IRIS-guided visualization (VG group) or blind insertion (CG group). One patient was excluded from the analysis due to a major protocol violation.

Procedural time was the primary outcome, while first-attempt success rate was secondary. Safety outcomes were adverse events and haemodynamic stability.

Of the remaining patients, 22 were in the VG group and 23 in the CG group. Patients in the VG group had a significantly shorter median procedural time (3.19 vs 22.52 min; 95 percent confidence interval [CI], –32.23 to –14.22; p<0.0001) and a higher first-attempt success rate (95.45 percent vs 69.57 percent; odds ratio, 9.19, 95 percent CI, 1.02–82.41; p=0.047) than those in the CG group.

In terms of safety, the incidence of adverse events and haemodynamic stability did not significantly differ between the two groups.

“While guided feeding tube placement has demonstrated superior efficacy to blind insertion, its clinical application remains constrained by technical and operational challenges,” the researchers said. “The IRIS addresses these limitations by combining continuous lumen visualization with device portability, potentially democratizing precise feeding tube placement.”