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Small bore feeding tubes are used to provide essential nutrition and medication to patients at risk of malnutrition and dehydration due to an inability to ingest orally (1).

Clogging is one of the most frequent mechanical complications of feeding tubes (2,3). Tubes are more likely to become clogged when powdered, crushed, acidic, or alkaline medications or ground feeding formulas containing particulates are delivered through the small inner lumen, or when tubes are not routinely flushed following feedings (2). Reported clogging rates vary, ranging from 9-35% (1, 2).

Attempts to clear clogged feeding tubes using various techniques are time-consuming and often result with tube replacement still being required. Also, many of the current methods only work on certain types of clogs. For example, most enzyme treatments are only applicable to protein (feeding formula) based clogs. Among common emergency room medical procedures, patients rank nasoenteral (NE), (nasogastric [NG]) tube insertion to be one of the most painful (4, 5, 6). Replacing a feeding tube may cause additional patient safety risks, associated medical costs, and additional pain and discomfort to the patient. The most common way to place NE (NG) feeding tubes, is blind insertion at patient bedside, and has a reported 0.5-15% malposition rate (3). Malposition into the trachea may cause pneumothoraxes and possibly death. Several methods exist for verifying accurate tube placement, the most reliable being radiography (3). However, this exposes patients to additional radiation and medical costs.

Taking into account nursing time, tube replacement, radiographs and other miscellaneous costs, the capability to clear a clogged feeding tube while it remains in the patient, could represent substantial savings to a medical facility not to mention reduced pain and discomfort to the patient. For patients outside the hospital, a clogged feeding tube often results in transportation and admission costs to the payer and anxiety to the patient.

The TubeClear System was developed to efficiently and effectively clear clogged feeding tubes while the tube remains in the patient (7). It is currently FDA cleared to unclog 10-18 Fr NE, NG, gastrostomy (G [including percutaneous endoscopic gastrostomy, PEG tubes]) and jejunostomy (J) feeding tubes in adults at bedside while the tube remains in the patient. The TubeClear System is also CE marked. The TubeClear System is comprised of a reusable Control Box to which a single-use Clearing Stem is attached. The Clearing Stem is inserted into the patient’s feeding tube by the licensed healthcare practitioner. The Clearing Stem moves backward and forward, and the tip works against the clog to mechanically disrupt and clear the feeding tube.

+ FDA Cleared for clearing occlusions / clogs in Feeding and Decompression Tubes in adult patients that have a Tube size of 6 to 18 Fr.

 

References:
1. Ireton-Jones C, DeLegge M. Handbook of Home Nutrition Support. Sudburry, MA: Jones and Bartlett; 2007
2. Beyer PL, Matarese LE, Gottschlich MM. Complications of enteral nutrition. 1998.
3. Blumenstein I, Shastri YM, Stein J. Gastroenteric tube feeding: techniques, problems and solutions. World J Gastroenterol. 2014;20(26):8505-8524.
4. Singer AJ, Richman PB, Kowalska A, Thode HC, Jr. Comparison of patient and practitioner assessments of pain from commonly performed emergency department procedures. Ann Emerg Med. 1999;33(6):652-658.
5. Bae KH, Jeong IS. [Pain perception of nurses and pain expression of patients in critical care units]. J Korean Acad Nurs. 2014;44(4):437-445.
6. Penrod J, Morse JM, Wilson S. Comforting strategies used during nasogastric tube insertion. J Clin Nurs. 1999;8(1):31-38.
7. TubeClear System- Clears Clogged Feeding Tubes. 2015;http://www.tubeclear.com/