Feeding Tube

1. Types: Delivery
   1. Nasogastric Tube
      1. Most commonly used as is physiologic and allows for large volume bolus feedings
   2. Nasoduodenal Tube (post-pyloric)
      1. Indicated if higher Aspiration Pneumonia risk, gastric dysmotility or obstruction
      2. Requires continuous delivery device
   3. Enterostomy tube (Gastrostomy or Jejunostomy)
      1. Indicated for anticipated enteral feeding beyond 4 weeks
2. Complications: Nasogastric or nasoduodenal Feeding Tubes
   1. Nasopharyngeal Erosions
   2. Sinusitis
   3. Otitis Media
   4. Esophagitis or Esophageal reflux
   5. Tracheoesophageal fistula
   6. Esophageal trauma (e.g. rupture of Esophageal Varices)
   7. Clogged or kinked Feeding Tube
   8. Secondary mechanical obstruction from Feeding Tube (pylorus obstruction or Small Bowel Obstruction)
3. Adverse Effects
   1. Nasal Discomfort
   2. Gagging
4. Prevention: Complication avoidance
   1. Periodic confirmation of Feeding Tube (depth marker, Xray)
   2. Flush Feeding Tube with water at each nutrition stop or after drug delivery
      1. Clogged tubes may be cleared with instillation of digestive enzymes dissolved in warm water
      2. Replace persistently clogged tubes