Frequency of changing enteral alimentation bags and tubing, and adverse clinical outcomes in patients in a long term care facility.
Enteral alimentation, given via nasogastric or gastrostomy tubes, is a well established practice to provide nutrition for patients with significant neurological injury. The frequency with which enteral feeding bags and tubes require change and potential adverse effects associated with bacterial contamination of tube feeds remain controversial. The authors studied different times between enteral feeding bag and tube changes, and the effect on adverse clinical outcomes in residents of a long term care facility. In the first study, residents were randomized to 24 h (n = 2), 48 h (n = 3) or 72 h (n = 6) tube feeding and bag changes with clinical status monitored in a standardized fashion for six months. In the second study, patients were randomized to 24 h (n = 6) or 72 h (n = 6) changes. Patient-days of follow-up were 382, 574 and 1000 for the three arms of the first study period and 556 and 496 for the two arms of the second study. No differences in potential clinical adverse events--including fever, gastrointestinal symptoms or pneumonia--were observed with different durations of tubing change. This study suggests it is appropriate to change alimentation tube and feeding bags every 72 h (rather than every 24 h). The less frequent changes will decrease supply costs and free nursing time for other activities.
S
S
Graham
M
M
McIntyre
J
J
Chicoine
B
B
Gerard
R
R
Laughren
G
G
Cowley
J
J
Morrison
F Y
FY
Aoki
L E
LE
Nicolle
D000368:Aged; D004750:Enteral Nutrition / Q000295:instrumentation*; D004866:Equipment Contamination; D006801:Humans; D008283:Maintenance; D012866:Skilled Nursing Facilities; D013997:Time Factors