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This is a single center, non-randomized feasibility clinical evaluation that is designed to affirm the safety of the ENVUE™ System guidance during the placement of the ENvizion Medical™ enteral feeding tubes.
Enteral nutrition is the preferred route for the provision of nutritional support in most critical ill patients with functional gastrointestinal tract. Achieving early enteral nutrition (EN) in critically ill patients is associated with fewer major complications, reduced mortality and length of hospital stay, and significant cost savings. It is estimated that approximately 1.2 million feeding tubes are placed blindly each year in the United States alone. Despite the obvious advantages of the enteral tube feeding, inadvertent placement of Enteral Feeding Tube (EFT) into the airway is relatively common and can result in significant pulmonary injury including pneumothorax and pneumonia. Airway misplacement occurs in 1.2- 4 % of blind EFT insertions, with 0.2 to 1.2% of all the feeding tube placements cause pulmonary complications to patients. The gold standard for detecting inadvertent placement of a feeding tube in the lungs is radiography. However, because of its cost, possible delay of feedings while waiting for radiography, and risk for radiation exposure, clinicians continue to seek for alternative methods to confirm correct placement.
All the above mentioned, emphasizes the fact that safe and effective delivery of nasoenteral tube feedings requires assurance that the feeding tube tip is in a proper position. The ENVUE™ System is an electromagnetic tracking system which tracks the path of the feeding tube during placement. The benefit of the system when EFT is misdirected into the pulmonary system is a real-time visual tracing, which may prompt users to withdraw the tube and reinsert it.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| EFT placement using ENVUE System | Experimental | Placement of the ENvizion Medical™ Enteral Feeding Tube (EFT) in the stomach or small intestine of adult patients who require feedings via the oro/ nasoenteric route, using the ENVUE™ System. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ENVUE System | Device | The ENvizion Medical™ ENVUE™ System is designed to aid qualified operators in the placement of the ENvizion Medical™ Enteral Feeding Tube™ into the stomach or small intestine. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Successfully Placed Enteral Feeding Tube | Enteral tube (EFT) can be placed in the correct anatomical position without occurrence of guidance-related adverse events. Procedure success was evaluated by comparing tube tip location according to the ENVUE System and abdominal and/or thoracic X-Ray. Guidance-related AEs were evaluated through the documentation of any guidance-related serious adverse events (SAE) or adverse events (AE) occurring during a subject's participation in the study. | During procedure visit |
| Measure | Description | Time Frame |
|---|---|---|
| Total Number of Placement Attempts | Number of placement attempts was evaluated by number of replacement and repositioning events, as defined below:
| During procedure visit |
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Inclusion Criteria:
Exclusion Criteria:
Patients must not have a history of:
Patients must not have a significant concomitant illness that would adversely affect their participation in the study
Female patients who are pregnant or lactating
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| Name | Affiliation | Role |
|---|---|---|
| Lewis Jacobson, MD | St.Vincent Hospital and Health Care Center, Inc. | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| St.Vincent Hospital and Health Care Center, Inc. | Indianapolis | Indiana | 46260 | United States |
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Of 48 enrolled participants, 46 met inclusion/ exclusion criteria and underwent a tube placement attempt. From these 46 participants, 43 completed a successful tube placement.
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| ID | Title | Description |
|---|---|---|
| FG000 | EFT Placement Using ENVUE System | Placement of the ENvizion Medical™ Enteral Feeding Tube (EFT) in the stomach or small intestine of adult patients who require feedings via the oro/ nasoenteric route, using the ENVUE™ System. ENVUE System: The ENvizion Medical™ ENVUE™ System is designed to aid qualified operators in the placement of the ENvizion Medical™ Enteral Feeding Tube™ into the stomach or small intestine. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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| ID | Title | Description |
|---|---|---|
| BG000 | EFT Placement Using ENVUE System | Placement of the ENvizion Medical™ Enteral Feeding Tube (EFT) in the stomach or small intestine of adult patients who require feedings via the oro/ nasoenteric route, using the ENVUE™ System. ENVUE System: The ENvizion Medical™ ENVUE™ System is designed to aid qualified operators in the placement of the ENvizion Medical™ Enteral Feeding Tube™ into the stomach or small intestine. |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Median |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Participants With Successfully Placed Enteral Feeding Tube | Enteral tube (EFT) can be placed in the correct anatomical position without occurrence of guidance-related adverse events. Procedure success was evaluated by comparing tube tip location according to the ENVUE System and abdominal and/or thoracic X-Ray. Guidance-related AEs were evaluated through the documentation of any guidance-related serious adverse events (SAE) or adverse events (AE) occurring during a subject's participation in the study. | Subjects who underwent a successful feeding tube placement using the ENvue system | Posted | Count of Participants | Participants | During procedure visit |
|
From the participant's tube placement procedure (day 0) to the end of of the follow-up visit (20-48 hours post tube placement)
Analysis was performed on all enrolled subjects (48 subjects)
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | EFT Placement Using ENVUE System | Placement of the ENvizion Medical™ Enteral Feeding Tube (EFT) in the stomach or small intestine of adult patients who require feedings via the oro/ nasoenteric route, using the ENVUE™ System. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Enteral feeding tube distal tip deattachement | Product Issues | Systematic Assessment | Between the feeding tube placement procedure and follow-up visit, the tip of the tube became detached from the rest of the tube. The tip tube left the patient's body in a natural manner (during bowel movements). |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Clinical Director | ENvizion Medical | +972-72-2288240 | anath@envizionmed.com |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jul 11, 2018 | Aug 9, 2020 | Prot_SAP_000.pdf |
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| Number of Retrograde Tube Migration Events | Tube Migration was defined as: Retrograde migration from desired placement position. | During follow-up visit (20-48 hours post tube placement) |
| Unable to pass through esophagus |
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| Obstruction by Endotracheal tube |
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| years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race/Ethnicity, Customized | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| Sedated | Count of Participants | Participants |
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| Obtunded | Count of Participants | Participants |
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| Endotracheal Tube | Count of Participants | Participants |
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| Secondary | Total Number of Placement Attempts | Number of placement attempts was evaluated by number of replacement and repositioning events, as defined below:
| 43 subjects underwent a successful feeding tube placement using the ENvue system. In total, 44 tubes were successfully placed- 1 subject pulled the tube out and a new tube was placed instead | Posted | Number | Number of placement attempts | During procedure visit |
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| Secondary | Number of Retrograde Tube Migration Events | Tube Migration was defined as: Retrograde migration from desired placement position. | 43 subjects underwent a successful feeding tube placement using the ENvue system. Of the Forty- three (43) subjects that completed a successful placement procedure, thirty-six (36) subjects underwent a successful tube tip position check at follow-up visit. | Posted | Number | Number of tube retrograde migration | During follow-up visit (20-48 hours post tube placement) |
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|
|
| 1 |
| 48 |
| 0 |
| 48 |
| 1 |
| 48 |
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Twelve months following the completion of the study, Investigator may publish the results of the study. Investigator shall provide sponsor advanced copies of any proposed publication sixty days prior to planned publication Sponsor will have sixty days to review the proposed publication.