Nasojejunal tube feeding in children: knowledge and practice

Area of Science:

• Pediatric Gastroenterology
• Medical Device Management
• Clinical Practice Improvement

Background:

• Nasojejunal (NJ) tubes are used in pediatric patients outside of intensive care settings.
• Current practice relies on limited evidence, historical data, and extrapolation from nasogastric tube management.
• There is a need for better evidence to guide the ongoing care and management of NJ tubes in children.

Purpose of the Study:

• To analyze historical caseload data for pediatric NJ tube use.
• To assess current practices and identify inconsistencies among healthcare professionals.
• To advocate for a more robust evidence base for NJ tube management in children.

Main Methods:

• Retrospective analysis of caseload data for 36 pediatric patients over five years.
• Surveys of healthcare professionals to evaluate current practices and concerns regarding NJ tube care.
• Description of local practices aimed at reducing reliance on X-ray for position confirmation.

Main Results:

• The study included children aged 0-13 years, with 95% under two years old.
• Patients had a median of 4 NJ tubes each, with a wide range (1-46).
• Surveys revealed significant inconsistencies in NJ tube care practices and concerns about radiation exposure from position checks.

Conclusions:

• Pediatric NJ tube management is characterized by limited evidence and practice variability.
• There are significant concerns regarding the frequency of tube changes and radiation exposure.
• A stronger, evidence-based approach is urgently needed to improve the safety and efficacy of NJ tube use in children.