Tubes for Feeding and Decompression Flashcards
Types of NGT
Salem Sump > 2 Lumens ( Feed/Decompress and VENT to Prevent Adherance to Stomach wall ( Best )
Levine Tube > Single Lumen , No Vent , So suction can cause mucosal injury
Triple Lumen > Long tube , Usually placed Endoscopic
most societies agree that NG tube decompression is effective for up to
up to 72 hours, after which the risks outweigh the benefits
NG tube placement for postoperative ileus is associated with
slower return to bowel function and higher likelihood of pulmonary complications
Unless patient has ileus and Vomiting
Post-pyloric feeding has been shown to
prevent aspiration of feeds
ICU patients have been found to have abnormal small bowel motility leading to
retroperistalsis and increasing the risk of aspiration when fed directly into the stomach
Patients with diseases or who have had procedures associated with gastric atony
require enteral feeds that are beyond the ligament of Treitz.
Nasoenteric tubes (NETs) are best suited for short-term
(< 6 weeks) use for nutritional assistance.
There are three main techniques for PEG/PEJ
(1) Sachs-Vine push technique
(2) Ponsky pull technique
(3) Russell external dilation.
Antibiotics should be given before the procedure.
Patients who are unable to maintain sufficient nutritional intake for more than 1 month, despite a functioning gastrointestinal tract
are candidates for a feeding tube placement
Jejunostomy tubes are required if the stomach is
absent or nonfunctioning as a result of gastroparesis or tumor
Placement of Feeding Tube done by
endoscopically (PEG, PEG/ J, DPEJ)
radiographically (PEG)
surgically (PEG, jejunostomy).
Immediately after placement of feeding tube what to do ?
-can be placed to gravity drainage
-After 4 to 6 hours, the tube can be used for medication delivery
-enteral feeds start 12 to 24 hours following the procedure.
how to decrease risk of perforation
reduced by maximizing endoscopic transillumination and using discrete finger palpation on the abdominal wall to identify a safe entry site.
In addition, laparoscopic assistance can be used.
If Deterioration of the feeding tube
presence of discoloration, irregular beading of the tube, and foul odor
Replacement tubes only be placed in the tract once the site has matured (approximately 4 weeks).
A Foley catheter temporary replacement If tube is unavailable.
Buried bumper syndrome (BBS)
internal bumper (the internal retention device) of the PEG tube migrates into or becomes embedded within the gastric or abdominal wall
