Accuracy of Water Delivery in Enteral Nutrition Pumps

Adequate delivery of both enteral formula and water in patients receiving enteral nutrition (EN) is critical. Pump accuracy has been identified as a factor impeding enteral formula delivery; however, rarely is enteral water delivery investigated. The purpose of this study was to explore accuracy of delivering 1 L of water by EN pumps using different flush volumes and hang heights.

Three EN pumps were used in vitro to flush 1 L of water at 50 mL every hour for 20 hours (50 mL, 20 times per day) and 500 mL every 4 hours for 8 hours (500 mL, 2 times per day) at 0 in. and 18 in. (or 45.72 cm) hang heights. Fifteen runs were conducted at each volume and hang height per pump. Actual delivered enteral water, remaining volume in enteral feeding bags, and volume reported per pump were recorded.

Hang height of 18 in. delivered a mean 3.91% (95% CI, 3.25-4.57) more water than bags hung at 0 in. (P < .0005). When delivering water in 500 mL increments, 1.57% (95% CI, 0.92-2.23) more water was delivered than when delivered in 50 mL increments (P < .005).

Appropriate hang height recommendations improve enteral water delivery in patients receiving EN. The most accurate setting was 500 mL at 18 in., resulting in accurate water delivery in 97.8% of runs, whereas 50 mL at 0 in. delivered accurately 17.8% of the time. Appropriate bag hang height and water delivery volume is critical to maintain hydration status of patients receiving EN.