The Pennsylvania State University, College of Nursing, University Park, Pennsylvania, USA.
Nutr Clin Pract. 2018 Feb;33(1):147-150. doi: 10.1002/ncp.10009. Epub 2018 Jan 11.
Clogged enteral feeding tubes remain a significant barrier to the delivery of nutrition, hydration, and medications to patients who cannot tolerate oral intake. There is limited research that compares the relative efficacy of different methods used to clear a clogged feeding tube. The objectives of this study were to better understand the factors that contribute to enteral feeding tube clogging and to test the efficacy of 3 methods for clearing clogged feeding tubes.
Three formulations of clogs were artificially created and tested in vitro and composed of various quantities of crushed medication (ie, aspirin) and 0.15 g coagulated protein (ie, tofu). The following 3 clog clearing strategies were tested on all clog types (n = 5 clogs/formulation/treatment): warm water flushes, an enzyme treatment, and an actuated mechanical occlusion clearing device.
The variable among the clog types that appears most responsible for decreased clearing success is the state of the coagulated protein. Dried-out protein appears to makes a greater difference than increasing the medication quantity. The actuated mechanical occlusion clearing device was significantly more successful (93%) when compared with warm water flushes (20%) and the commercially available enzyme treatment (33%; P < .005) at clearing the clogs. The actuated device required significantly less total procedure time (P < .005) and total nursing time (P < .005) when compared with the other 2 clearing methods.
When clogs occur, they can be quickly and effectively resolved by the actuated device, but other methodologies such as water and enzyme treatments may be of assistance.
对于不能经口摄入的患者,堵塞的肠内喂养管仍然是输送营养、水和药物的重大障碍。目前,关于不同方法清除堵塞的肠内喂养管的相对疗效的研究有限。本研究的目的是更好地了解导致肠内喂养管堵塞的因素,并测试 3 种清除堵塞的肠内喂养管的方法的疗效。
在体外人工创建并测试了 3 种堵塞物配方,由各种数量的粉碎药物(例如阿司匹林)和 0.15 g 凝固蛋白(例如豆腐)组成。对所有堵塞类型(每种配方/治疗/5 个堵塞)测试了以下 3 种堵塞清除策略:温水冲洗、酶处理和驱动式机械闭塞清除装置。
在导致清除成功率降低的堵塞类型变量中,凝固蛋白的状态似乎是最重要的。干燥的蛋白质似乎比增加药物数量更有影响。与温水冲洗(20%)和市售酶处理(33%)相比,驱动式机械闭塞清除装置在清除堵塞物方面明显更成功(93%比 20%和 33%;P <.005)。与其他 2 种清除方法相比,驱动式装置所需的总程序时间(P <.005)和总护理时间(P <.005)明显更少。
当堵塞发生时,驱动式装置可以快速有效地解决,但其他方法,如水和酶处理,可能也有帮助。