The efficacy of feeding tubes: confirmation and loss

Area of Science:

• Medical Devices
• Gastroenterology
• Clinical Nutrition

Background:

• Enteral tube feeding is crucial for approximately 5% of hospital patients.
• The cost-effectiveness and efficacy of enteral feeding methods require further investigation.
• Current practices for tube confirmation and management present challenges.

Purpose of the Study:

• To compare the costs and efficacy of polyurethane tubes (PUTs) versus polyvinylchloride (PVC) Ryles tubes for enteral feeding.
• To analyze reasons for repeat X-ray confirmations and tube dislodgement.
• To evaluate current tube confirmation methods and identify areas for improvement.

Main Methods:

• A comparative study of consecutive patients using either PVC Ryles tubes or CORFLO® PUTs for enteral feeding.
• Radio-opacity, reasons for repeat X-ray, and overall costs were examined.
• Tube confirmation methods and reasons for tube loss during the enteral feeding episode were recorded.

Main Results:

• Despite higher initial costs, PUTs and PVC Ryles tubes showed similar overall costs when X-ray confirmation was used, due to fewer repeat X-rays needed for PUTs (0% vs. 26%).
• X-ray confirmation (51%) remained more common than pH testing (45%).
• Inadvertent patient removal accounted for the majority of tube loss (54%).

Conclusions:

• When using X-ray confirmation, the costs of PUTs and PVC Ryles tubes are comparable.
• X-ray remains the predominant confirmation method, suggesting potential cost savings with PUTs if staff and outcome costs are considered.
• There is a need for more reliable bedside confirmation methods, and nasal bridles may prevent a significant portion of tube loss.