Causes of nasoenteral tube obstruction in tertiary hospital patients

• Published in: European journal of clinical nutrition 2020-02, Vol.74 (2), p.261-267
• Main Authors: Borges, José L. A., De Souza, Ivens A. O., Costa, Michele C. V., Ruotolo, Fabiana, Barbosa, Livia M. G., De Castro, Isac, Ribeiro, Paulo C.
• Format: Article
• Language: English
• Subjects: 692/700/2814; 692/700/565/2072; Anticoagulants; Antidiabetics; Antifungal agents; Clinical Nutrition; Diet; Drug delivery; Drug delivery systems; Enteral nutrition; Epidemiology; High protein diet; Hospital patients; Internal Medicine; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Metabolic Diseases; Metformin; Nutrition; Nutrition research; Nutrition therapy; Nystatin; Population studies; Public Health; Rivaroxaban; Therapy; Tubes
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/s41430-019-0475-0

Background/objectives Obstruction of the nasoenteral tube is one of the complications of enteral nutrition therapy, and its causes and frequency of occurrence are not well understood. To evaluate the causes of enteral nutrition feeding tube obstruction. To study the time elapsed between the beginning of the nutrition therapy and the obstruction of the tube. Subjects/methods This was a retrospective cohort study of 1170 patients aged 18 years or older who were hospitalized at Sírio-Libanês Hospital between January 2015 and October 2017, and who were undergoing enteral nutrition therapy delivered using an infusion pump through a nasogastric or nasoenteral tube. The study population included 683 (58%) men and 487 (42%) women. The median age was 79 years. Of these, 1084 patients received enteral nutrition and medication through the feeding tube, and 86 received medication alone. Variables investigated as causes of feeding tube obstruction were the administration of medication through the tube, type of diet, and use of symbiotics. Results Obstruction rates were 4% for up to 40 days of observation and 8% for the total observation time. The time for obstruction of 10% of the tubes in patients receiving rivaroxaban, linagliptin, metformin, and nystatin was 16, 19, 20, and 28 days, respectively. Conclusions The main cause of nasoenteral tube obstruction (odds ratio) was the combination of metformin (2.0), nystatin (3.1), linagliptin (4.3), rivaroxaban (2.4), and a high-protein diet (1.9). Overall, proper tube care and strict compliance with tubal drug delivery guidelines can result in low tube obstruction rates.