Electromagnetic-Guided Nasojejunal Tube Placement in Pediatrics: A case report and literature review

Background Electromagnetic-guided (EM-guided) placement is one of the methods for inserting a nasojejunal tube (NJT). It has gained increasing recommendations from healthcare institutions due to its bedside applicability, avoiding the need for anaesthesia and patient transfer. Despite being considered a relatively mature technique, pediatric patients pose more significant challenges for tube placement compared to adults. Methods Three nurses with over a decade of experience in feeding tube placement used Cortrak® 2 Smart Receiver Unit to insert NJT in pediatric patients. Results Successful tube placement was achieved in all six pediatric patients. Among them, two cases under 3 years old exhibited incomplete Cortrak curves, and one displayed an atypical Cortrak curve, one presented an atypical X-ray image, and one demonstrated a discrepancy between the Cortrak curve and X-ray images. Conclusion EM-guided nasojejunal tube placement (NJTP) can be a valuable alternative for pediatric patients who cannot undergo anaesthesia or transfer. Nonetheless, performing this procedure in children presents inherent challenges, and even in instances of successful placement, a conventional curve may not be discernible. Additionally, the small size of pediatric patients may lead to a mismatch with the receiver, causing incomplete image display, and confusion for operators.