BC participated in the design of the study and performed the statistical analysis. BKC was responsible for the logistic coordination of the study, was involved in the design of the study, in statistical analysis and interpretation of data and helped to draft the Ivacaftor cystic fibrosis manuscript. FM initiated and coordinated the study and was involved at all steps of the study. All authors read and approved the manuscript.Supplementary MaterialAdditional file 1:FIRST Study Group. A full list of participants for the FIRST Study Group.Click here for file(13K, DOCX)AcknowledgementsThis study was supported by the Programme Hospitalier de Recherche Clinique 2003 of the French Ministry of Health (National PHRC), the Soci��t�� Fran?aise d’Anesth��sie R��animation (SFAR) and the Centre Hospitalier Universitaire de Dijon.

We thank physicians of SAMU/SMUR, emergency and intensive care units who participated in the FIRST study, and all research assistants and data managers of the Centre d’Investigation clinique – Epid��miologique clinique du CHU de Dijon (INSERM CIE 01), Dijon, France.Steering committee: Claire Bonithon-Kopp, Jacques Duranteau, Claude Martin, Bruno Riou, Jean-Michel Yeguiayan, Marc Freysz (study coordinator).A full list of the participants of the FIRST Study Group can be found in Additional file 1, available with the online version of this paper.
Feeding the critically ill patient should be preferentially accomplished via the enteral route [1,2]. A recent meta-analysis revealed that mortality and the incidence of pneumonia were significantly reduced in patients with enteral nutrition within 24 hours [3].

Parenteral nutrition may be associated with higher mortality [4].Intolerance of gastric feeding and high gastric volumes are the main obstacles for enteral nutrition [5]. If intragastric feeding fails despite prokinetic therapy with erythromycin and metoclopramide it is recommended to place a feeding tube into the jejunum without delay. The advantages of postpyloric feeding are a lower incidence of regurgitation and microaspiration and improved tolerance of enteral nutrition [6-8].Various methods of endoscopic placement of nasoenteral feeding tubes exist [9]. The standard bedside procedure requires transoral endoscopy. Another method introduces the tube through the instrument channel of the endoscope with subsequent transfer from the oral to the nasal cavity [10].

These procedures usually are performed by an experienced endoscopist. When Carfilzomib the endoscopist is not available the recommended start of enteral nutrition within the first 24 hours may be delayed. Self-advancing tubes could be an alternative; however, the correct placement of these tubes may take a long time [11].To solve these problems and to provide the intensive care unit (ICU) physician with an easy bedside method for rapid placement of feeding tubes, a new endoscope was developed.