Factors such as narrow tube internal diameter, longer feeding tubes, tube tip location, slow feeding infusion rates, and formation of EN formula precipitate from contact with acidic gastric secretions contribute to the risk of tube clogging.
Escuro, A.A., Burns, B., McLaughlin, K., Lopez, R. and Cresci, G.A. (2020), Dietitians’ Evaluation of Clearing Luminal Occlusions of Gunk (DECLOG): A Pilot Feasibility Study. Nutrition in Clinical Practice, 35: 142-148. https://doi.org/10.1002/ncp.10318
Before a medication in a solid dosage form is administered through a feeding tube, it should be determined if the medication is suitable for manipulation, such as crushing a tablet or opening a capsule.
Williams NT. Medication administration through enteral feeding tubes. Am J Health Syst Pharm. 2008 Dec 15;65(24):2347-57. doi: 10.2146/ajhp080155. PMID: 19052281.
Obstruction in feeding tubes was reported in 95% of the admixtures with incompatibility.
Managing the schedule of administration of nutrition and medication, and giving enough interval time between medications will theoretically reduce the incidence of medication-nutrition interactions, and diminish incompatibilities that cause obstructions.
Hosam Mohammed Alsamet, Considerations regarding oral medications delivery to patients on nasoenteral tubes,Nutrition Clinique et Métabolisme, Volume 36, Issue 1, 2022, Pages 21-27, https://doi.org/10.1016/j.nupar.2021.09.002.
Delivery of nutrition support to patients at nutrition risk could save the Medicare program up to $580 million per year by shortening the length of stay and complication avoidance.
Tyler, R., Barrocas, A., Guenter, P., Araujo Torres, K., Bechtold, M.L., Chan, L.-N., Collier, B., Collins, N.A., Evans, D.C., Godamunne, K., Hamilton, C., Hernandez, B.J.D., Mirtallo, J.M., Nadeau, W.J., Partridge, J., Perugini, M., Valladares, A. and (2020), Value of Nutrition Support Therapy: Impact on Clinical and Economic Outcomes in the United States. Journal of Parenteral and Enteral Nutrition, 44: 395-406. https://doi.org/10.1002/jpen.1768
Uncertainty in the literature about feeding tube choices, practices, and transitions requires clinicians to draw on incomplete and sometimes conflicting evidence, personal experience, economic realities, and compassion to deliver supportive care.
Abdelhadi, R.A., Rempel, G., Sevilla, W., Turner, J.M., Quet, J., Nelson, A., Rahe, K., Wilhelm, R., Larocque, J., Guenter, P. and (2021), Transitioning From Nasogastric Feeding Tube to Gastrostomy Tube in Pediatric Patients: A Survey on Decision-Making and Practice. Nutrition in Clinical Practice, 36: 654 664. https://doi.org/10.1002/ncp.10603