Multi-dimensional factors and intervention strategies for nasoenteric tube dysfunction: research progress and future...

Nasoenteric tube (NET) is indispensable for the delivery of enteral nutrition for hospitalized patients. However, their clinical utility is frequently compromised by dysfunction-related complications, including tube malposition, obstruction and displacement. These issues disrupt nutritional therapy, escalate healthcare costs, and exert adverse impact on patient outcomes. Here, we review the multi-factorial etiology of NET dysfunction, encompassing tube-related factors (material properties, structural design and fixation techniques), treatment protocols (nutritional formulation physicochemical properties, drug-nutrient interactions and infusion protocols), nursing practices (flushing practices and errors in the administration of medications) and patient factors (cognitive impairment and non-compliance). To mitigate these issues, we propose intervention strategies, including tube optimization, such as the adoption of polyurethane tubes and guided placement techniques (ultrasound/X-ray) to minimize malposition; protocol standardization (implementing ASPEN guidelines for the administration of medications, including pre-/post-flushing with 30 ml of warm water and avoiding crushed extended-release drugs; multidisciplinary training, such as enhancing the competency of caregivers via education relating to tube maintenance and drug-nutrient compatibility; and patient-tailored strategies, such as using nasal bridle fixation for high-risk patients and sedation protocols for those with cognitive impairment. this review provides a theoretical foundation to optimize the clinical management and efficacy of nutritional therapy. Future research should prioritize the development of risk stratification tools that combine material science, patient factors, and nursing practice to pre-emptively identify high-risk cases and develop integrated scoring systems to evaluate synergistic effects in relation to the cognitive status of patients, tube properties, and nutritional formula viscosity.