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Covid19 prone EN-Tuesday Tube Facts

Did you know…?

For COVID-19 ICU patients in the prone position, enteral nutrition in the stomach is generally well-tolerated.[1]

On occasion, postpyloric placement of the feeding tube may be indicated. Placement of postpyloric tubes increases exposure to SARS‐CoV‐2, and thus their use should be considered only on a case‐by‐case basis in patients with COVID‐19.[1]

References:

  1. Patel, J.J., Martindale, R.G. and McClave, S.A. (2020), Relevant Nutrition Therapy in COVID‐19 and the Constraints on Its Delivery by a Unique Disease Process. Nutrition in Clinical Practice, 35: 792-799. doi:10.1002/ncp.10566.

COVID EN Tube Type-Tuesday Tube Facts

Did you know…?

Small-diameter feeding tubes (10-12 French) are recommended for COVID-19 patients in the ICU who require enteral nutrition.[1]

References:

  1. Martindale, R., Patel, J., Taylor, B., Warren, M., McClave, S. Nutrition Therapy in the Patient with COVID-19 Disease Requiring ICU Care. Reviewed and Approved by the Society of Critical Care Medicine and the American Society for Parenteral and Enteral Nutrition. May 27, 2020. https://doi.org/10.1002/jpen.1930

ICU LOS Increase with EN Interruption-Tuesday Tube Facts

Did you know…?

For critically ill surgical patients, interruptions to EN increases length of ICU stay by 1.5 days.

[1]

References:

  1. Peev, M. P., Yeh, D. D., Quraishi, S. A., Osler, P. , Chang, Y. , Gillis, E. , Albano, C. E., Darak, S. and Velmahos, G. C. Causes and Consequences of Interrupted Enteral Nutrition. Journal of Parenteral and Enteral Nutrition. 2015. 39: 21-27.

Clogging: A Frequent Complication in EADs – Tuesday Tube Facts

Did you know…?

Clogging is one of the most frequent mechanical complications of feeding tubes.[1,3]

Reported clogging rates vary from 9 – 35%.[1-7] With clogging of nasogastric (NG) feeding tubes considered under-reported, the actual rate may be much higher.[3]

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. Pancorbo-Hidalgo PL, García-Fernandez FP, Ramírez-Pérez C. Complications associated with enteral nutrition by nasogastric tube in an internal medicine unit. J Clin Nurs. 2001;10(4):482-490.
  5. Marcuard SP, Stegall KS. Unclogging feeding tubes with pancreatic enzyme. JPEN J Parenter Enteral Nutr. 1990;14(2):198-200.
  6. Frizzi JD, Ray PD, Raff JB. Enteral nutrition by a forward surgical team in Afghanistan. South Med J. 2005;98(3):273-278.
  7. Bourgault AM, Heyland DK, Drover JW, Keefe L, Newman P, Day AG. Prophylactic pancreatic enzymes to reduce feeding tube occlusions. Nutr Clin Pract. 2003;18(5):398-401.

Starting EN More than 3 Days After ICU Admission – Tuesday Tube Facts

Starting EN More than 3 Days After ICU Admission – Tuesday Tube Facts

Starting enteral nutrition more than 3 days after ICU admission was associated with increased length of stay.

Critically ill patients should be started on enteral tube feeds within 48 hours of intubation whenever possible.

1. Bourgault, A.M., Ipe, L., Weaver, J., Swartz, S., O’Dea, P.J. Development of Evidence-Based Guidelines and Critical Care Nurses ’ Knowledge of Enteral Feeding. Critical Care Nurse, 2007; 27(4):17-29.

2. Fremont, R. D., Rice, T.W. How soon should we start interventional feeding in the ICU? Curr Opin Gastroenterol. 2014 March; 30(2): 178–181.