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Related Experiment Videos

Clogging of feeding tubes.

S P Marcuard1, A M Perkins

  • 1Department of Medicine, East Carolina University School of Medicine, Greenville, North Carolina 27858.

JPEN. Journal of Parenteral and Enteral Nutrition
|July 1, 1988
PubMed
Summary

Some liquid nutritional formulas can clot, potentially causing feeding tube blockages. This risk is higher with intact protein formulas and acidic conditions, necessitating careful administration practices.

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Area of Science:

  • Nutritional Science
  • Biochemistry
  • Gastroenterology

Background:

  • Liquid nutritional formulas are crucial for patients unable to consume food orally.
  • Formula clotting in feeding tubes is a significant clinical challenge, leading to complications and treatment interruptions.
  • Understanding the factors influencing formula stability is essential for safe and effective enteral nutrition delivery.

Purpose of the Study:

  • To investigate the in vitro clotting potential of various commercially available liquid nutritional formulas.
  • To evaluate the impact of protein source (intact vs. hydrolyzed) and pH on formula clotting.
  • To identify specific formulas prone to clotting and provide insights into preventing feeding tube occlusion.

Main Methods:

  • An in vitro study was conducted using 10 different commercial formulas.
  • Formulas were tested across a pH range of 1 to 10, with some tested at full and half strength.
  • Protein (10 and 20 g/liter) was added to select formulas to assess its effect on clotting.

Main Results:

  • Clotting was observed exclusively in premixed, intact protein formulas (Pulmocare, Ensure Plus, Osmolite, Enrich, Ensure) and Resource.
  • No clotting occurred in powdered intact protein formulas (Citrotein), hydrolyzed protein formulas (Vital, Vivonex TEN), or Hepatic Aid II.
  • Supplementation with additional protein did not induce or exacerbate clotting in the tested formulas.

Conclusions:

  • Certain liquid nutritional formulas, particularly those with intact protein, exhibit a propensity for clotting in vitro.
  • Formula clotting poses a risk for gastric feeding tube occlusion.
  • Preventive strategies include proper tube flushing, duodenal advancement of feeding tubes, and avoiding mixing with acidic medications (pH ≤ 5.0).

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