Enteral nutrition is also known as tube feeding. Different types of tubes can be used in order to deliver this type of feeding. One of the most commonly used once, which is also employed with the Kangaroo feeding pumps, is the nasoenteric tube. This tube enters the stomach or the bowel through a patient’s nose. There are different types of nasoenteric tubes, including naso jejunal (NJ), naso duodenal, and naso gastric (NG). There are also non-nasal feeding options, for instance where the tube is inserted straight into the bowel or stomach through the skin. This is known as enterestomy feeding, for which the percutaneous endoscopic jejunostomy or the percutaneous endoscopic gastrostomy is used.
Nasoenteric Feeding Tubes – The Most Commonly Used Tubes with Kangaroo Feeding Pumps
The NG and NJ tubes are used when someone is likely to require nutritional support for a short period of time, or where the patient is in such ill health that a more intrusive procedure is not recommended.
In case of an NG procedure, the tube is inserted through the nasal cavity, after which it travels through the back of the throat and then the esophagus. Eventually, it reaches the stomach. Sometimes, the tube has to go further, until it reaches the small bowel, medically called the jejunum. In this case, the NJ tube is required.
Nasoenteric tubes can get displaced on the internal end, and there are no visual indicators of this. As a result, before drugs, feed, or water is administered, the tube has to be checked. To do this, a health care worker will aspirate some of the jejunal or gastric content and test its acidity with a pH stick. If the pH is between 6 and 8, it is present in the small bowel. If the pH is below 5.5, it is positioned in the stomach.
How Feed Is Administered
There are three main methods to administer feed:
- Bolus, whereby food is administered over a course of 15 to 20 minutes, usually through a syringe. This is done several times per day.
- Intermittent gravity drip, whereby a volume is administered over half an hour to an hour, generally a few times per day.
- Continuous, whereby the feed solution is administered over an eight to 24 hour period. This is where the Kangaroo feeding pump is absolutely vital.
With NJ feeders, there isn’t much flexibility on how the feed is delivered, unfortunately. This is because the solution goes straight into the bowel. When a tube enters the stomach, the solution is stored there as if someone actually ate the nutrition. Therefore, even if large volumes are held, this doesn’t lead to any complications. However, there is not storage ability in the small intestine, which means there is always a risk of overfeeding, leading to dumping syndrome. Clearly, therefore, it is vital that a full multidisciplinary medical team works together with the patient to determine which feeding option will be most beneficial and least likely to lead to complications.