Flow efficiency of 3D-printed refeeding tubes in a simulated neonatal high-output stoma model

Neonatal enterostomies often cause high-output losses of intestinal contents, leading to malabsorption, growth failure, and dependence on parenteral nutrition. Conventional refeeding relies on intermittent or continuous reinfusion and may entail contamination risk and technical difficulties.

This study introduces an indwelling tube refeeding approach that connects the proximal and distal bowel through a single continuous tube, enabling uninterrupted physiological flow. Using a bench-top in vitro model simulating a neonatal high-output stoma, nine three-dimensional -printed tubes (three diameters × three configurations) were tested at two infusion rates (100 and 50 mL/h).

All 90 trials achieved continuous distal outflow without occlusion, confirming technical feasibility. Flow efficiency increased with tube diameter: at 100 mL/h, efficiencies were 95.2 ± 5.2% (9 mm), 62.5 ± 12.3% (7 mm), and 55.5 ± 8.6% (5 mm); a similar pattern was observed at 50 mL/h. Tube configuration and infusion rate had minimal effects on flow efficiency.

This bench-top study demonstrates the feasibility of an indwelling bridging tube for continuous proximal-to-distal transfer in vitro. Although larger diameters achieved higher flow efficiency, smaller-caliber tubes occupying approximately 40% of the lumen still achieved > 56% efficiency in this model; however, clinical safety and efficacy require further biomechanical and in vivo validation.