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).
Clearing clogged feeding tubes creates hassles and frustration for practitioners and anxiety and discomfort for patients. The lapse in nutrition and medication regime may also negatively impact recovery (4). Standard techniques for clearing clogged feeding tubes in the past included enzymes, Coca-Cola®, and meat tenderizer. Today, commercially available manual brushes and stylets exist, in addition to enzymes or syringe water flushes (2,5,6). Attempts to clear clogged feeding tubes using these techniques are time-consuming and often result with tube replacement still required. Moreover, among other common medical procedures, patients rank Nasoenteral (NE, nasogastric [NG]) tube insertion to be one of the most painful (7,8,9).
The TubeClear System, an FDA-cleared and CE marked medical device, was developed to clear clogged feeding tubes at bedside while the tube remains in the patient. The system comprises of a reusable Control Box that actuates a single-use Clearing Stem. The Clearing Stem inserts into the feeding tube and the backward and forward movement of the Clearing Stem acts to mechanically disrupt the clog and clear the clogged feeding tube (10).
A bench study was conducted to test the efficacy of three different clog-clearing strategies on in-vitro clogged tubes. Of the three clog clearing strategies tested with artificially clogged tubes, warm water flushes and commercially available enzyme treatments took significantly longer to clear clogged feeding tubes, when compared to the TubeClear System.
- FDA Cleared for clearing occlusions / clogs in Feeding and Decompression Tubes in adult patients that have a Tube size of 6 to 18 Fr.
Using TubeClear to Unclog Nasoenteral tubes that reside in the stomach.
Benchtop Study evaluated at AMI with Levin 14Fr, 48 inch long feeding tubes with in-vitro clogs. Occlusions were made from 1:1 ratio of feeding formula and fiber.
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- Blumenstein I, Shastri YM, Stein J. Gastroenteric tube feeding: techniques, problems and solutions. World J Gastroenterol. 2014;20(26):8505-8524.
- Pearce C, Duncan H. Enteral feeding. Nasogastric, nasojejunal, percutaneous endoscopic gastrostomy, or jejunostomy: its indications and limitations. Postgrad Med J. 2002;78(918):198-204.
- Metheny N, Eisenberg P, McSweeney M. Effect of feeding tube properties and three irrigants on clogging rates. Nurs Res. 1988;37(3):165-169.
- Smith R, Myers S. 2 devices that unclog feeding tubes. RN. 2005;68(1):36-41; quiz 42.
- 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.
- 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.
- Penrod J, Morse JM, Wilson S. Comforting strategies used during nasogastric tube insertion. J Clin Nurs. 1999;8(1):31-38.
- TubeClear System- Clears Clogged Feeding Tubes. 2015;https://www.tubeclear.com/