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ICU Nutritional Practice-Tuesday Tube Facts

Did you know…?

For enteral Covid-19 patients, feeding tube placement and aspiration are potential aerosol generating procedures.[1]

Tip to decrease Covid-19 exposure due to aerosol generating procedures: Decrease exposure by quicker gastric tube placement rather than postpyloric placement.[3]

References:

  1. Rimensberger, Peter C., et al. “Caring for Critically Ill Children with Suspected or Proven Coronavirus Disease 2019 Infection: Recommendations by the Scientific Sections’ Collaborative of the European Society of Pediatric and Neonatal Intensive Care.” Pediatric Critical Care Medicine, vol. 22, no. 1, 2020, pp. 56–67., doi:10.1097/pcc.0000000000002599.

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.