Unclogging enteral feeding tubes: A systematic review

Area of Science:

• Medical Interventions
• Gastroenterology
• Patient Safety

Background:

• Enteral feeding tube occlusion is a common complication.
• Existing interventions lack comparative effectiveness data.
• This review addresses the gap in knowledge regarding occlusion resolution methods.

Purpose of the Study:

• To systematically review and compare the efficacy of different interventions for enteral feeding tube occlusions.
• To synthesize evidence on water flushes, enzymatic agents, and mechanical devices.
• To inform clinical practice regarding the management of feeding tube occlusions.

Main Methods:

• Systematic literature search of major databases (PubMed, Cochrane, Scopus, ScienceDirect, ClinicalTrials.gov).
• Inclusion of in vivo and in vitro studies following PRISMA 2020 guidelines.
• Comparative analysis of intervention success rates.

Main Results:

• Mechanical interventions showed high success rates (93% for actuated devices).
• Alkalinized non-enteric-coated pancreatic enzymes were effective (63.5% overall, 96% for formula clogs).
• Warm water flushes demonstrated limited efficacy (20%-27%).

Conclusions:

• Actuated mechanical devices offer the highest in vitro efficacy.
• Alkalinized non-enteric-coated pancreatic enzymes are highly effective, especially for formula-based occlusions.
• A sequential approach (warm water, then mechanical or enzyme escalation) is suggested despite low evidence certainty.