Enteral Access Devices: Types, Function, Care, and Challenges

Abstract

Enteral access feeding devices are placed in patients who have a functional and accessible gastrointestinal (GI) tract but are not able to consume or absorb enough nutrients to sustain adequate nutrition and hydration. For many individuals, enteral nutrition support is a lifesaving modality to prevent or treat a depleted nutrient state that can lead to tissue breakdown, compromised immune function, and poor wound healing. Psychological well-being is also affected with malnutrition and dehydration, triggering feelings of apathy, depression, fatigue, and loss of morale, negatively impacting a patient's ability for self-care. A variety of existing devices can be placed through the nares, mouth, stomach or small intestine to provide liquid nutrition, fluids, and medications directly to the GI tract. If indicated, some of the larger-bore devices may be used for gastric decompression and drainage. These enteral access devices need to be cared for properly to avert patient discomfort, mechanical device-related complications, and interruptions in the delivery of needed nutrients, hydration, and medications. Clinicians who seek knowledge about enteral access devices and actively participate in the selection and care of these devices will be an invaluable resource to any healthcare team. This article will review the types, care, proper positioning, and replacement schedules of the various enteral access devices, along with the prevention and troubleshooting of potential problems.

ESPEN guideline on home enteral nutrition

“…This problem is further exacerbated the longer the feeding tube is and if medications are administered through the tube. Tubes should be flushed with at least 30 mL of water of drinking quality before starting and after completion of feeds in case of bolus administration or 4-hourly if continuous feeding [91].…”

Development and Psychometric Testing of a Questionnaire to Assess Nurse’s Perception of Risks during Enteral Nutrition

“…The purpose of this study was to develop and psychometrically test the questionnaire, a new instrument to measure risk perception of EN among nurses, for addressing three questions: (1) what are the psychometric properties of the questionnaire; (2) what are the factors of the questionnaire; (3) if the questionnaire can reliably and effectively measure the EN risk perception among Chinese nurses.…”

“…Enteral nutrition (EN) is an effective method of providing nutritional support to patients with functional gastrointestinal tract who are unable to meet their nutritional requirements orally [1,2]. Due to its convenient use characteristics and therapeutic advantages, it has been widely used in clinical practice.…”

Incidentes relacionados ao uso de sondas nasogástricas e nasoentéricas: Um estudo de coorte com idosos hospitalizados

“…Fr é uma escala padronizada do diâmetro externo de sondas e cateteres no qual 1Fr=0,33mm (MARINO, 2015). Na prática clínica as sondas nasogástricas feitas de polivinil de calibres maiores, 14-18Fr, são utilizadas com objetivo de descompressão gástrica e drenagem, bem como meio de administração de dieta no início da nutrição enteral em pacientes que estão saindo do jejum após um período de drenagem gástrica, seu uso é indicado por períodos menores que 30 dias, pois em períodos maiores seu material sofre alterações no pH estomacal (TRONCON et al, 2000;LORD, 2018).…”

“…Contudo, sondas de maior calibre não são as ideais para alimentação por serem mais desconfortáveis e por aumentarem os riscos de sinusites e de lesões por pressão (LORD, 2018 -Nulos -ausência de sintoma detectado e de tratamento;…”