feeding tube
Jump to navigation
Jump to search
Introduction
Also see medications via enteral tube
Indications
- nutritionally support patients unable to eat, but with intact gastrointestinal tract
- gastrostomy is indicated for long term enteral nutrition
Contraindications
- advanced dementia[7]
- assisted oral feeding oral feeding may be preferable, especially in a nursing home setting[10]
- feeding tubes do not prolong survival, reduce incidence of pneumonia, improve function, or reduce incidence or severity of pressure ulcers in patients with advanced dementia[5]
Procedure
- tube placement either through the nasapharynx into the stomach or small intestine or directly through the abdominal wall
- nasojejunal tube may be indicated when high residual volumes occur with a nasogastric tube or for avoidance of pancreatic secretion after acute pancreatitis
Complications
- increased incidence of aspiration pneumonia
- reports of pneumothorax with 2 of the 3 FDA-approved enteral access systems[9]
- metabolic disturbances (electrolyte imbalance)[6]
- diarrhea
- cellulitis at gastrostomy site[6]
- interference with absorption of Sinemet & phenytoin[6]
- increased use of physical restraints
- increased emergency department visits (for feeding tube malfunction)
Management
- elevate head of bed if supine
- see enteral nutrition
Notes
- feeding tubes may be too frequently placed in demented patients[3]
- feeding tube use declined 2000-2014
- use is higher in black nursing home residents than white nursing home residents[8]
More general terms
More specific terms
Additional terms
- enteral nutrition
- gastrostomy
- medications via enteral tube
- nasogastric tube (NGT) placement (gastric intubation)
- nasojejunal tube
References
- ↑ Journal Watch 21(19):152, 2001 Heyland et al Crit Care Med 29:1495, 2001
- ↑ Journal Watch 22(8):62, 2002 Davis AR et al, Crit Care Med 30:586, 2002
- ↑ 3.0 3.1 Teno JM et al. Hospital characteristics associated with feeding tube placement in nursing home residents with advanced cognitive impairment. JAMA 2010 Feb 10; 303:544. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20145231
- ↑ Lopez RP, Amella EJ, Strumpf NE, et al. The influence of nursing home culture on the use of feeding tubes. Arch Intern Med 2010; 170(1):83-88. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20065203
- ↑ 5.0 5.1 Teno JM et al Does feeding tube insertion and its timing improve survival? J Am Geriatr Soc. 2012 Oct;60(10):1918-21. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23002947
- ↑ 6.0 6.1 6.2 6.3 Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
- ↑ 7.0 7.1 American Geriatrics Society (AGS) Feeding Tubes in Advanced Dementia Position Statement. May 2013 http://www.americangeriatrics.org/files/documents/feeding.tubes.advanced.dementia.pdf
American Geriatrics Society Ethics Committee and Clinical Practice and Models of Care Committee. American Geriatrics Society feeding tubes in advanced dementia position statement. J Am Geriatr Soc 2014 Aug; 62:1590 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25039796 - ↑ 8.0 8.1 Mitchell SL, Mor V, Gozalo PL et al. Tube feeding in US nursing home residents with advanced dementia, 2000-2014. JAMA 2016 Aug 16; 316:769. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27533163 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=2544627
- ↑ 9.0 9.1 Brooks M Pneumothorax Events Linked to Placement of Enteral Feeding Tube. Medscape: January 11, 2018 https://www.medscape.com/viewarticle/891200
FDA MedWatch. Jan 11, 2018 CORRECTION - Feeding Tube Placement Systems: Letter to Health Care Providers - Reports of Pneumothorax Events. Link broken. - ↑ 10.0 10.1 Hanson LC Tube Feeding vs Assisted Oral Feeding for Persons With Dementia: Using Evidence to Support Decision-Making. Annals of Long-Term Care, 2013. Jan https://www.hmpgloballearningnetwork.com/site/altc/articles/tube-feeding-versus-assisted-oral-feeding-persons-dementia-using-evidence-support-decision