The Selection and Care of Enteral Feeding Tubes
The Selection and Care of Enteral Feeding Tubes
The Selection and Care of Enteral Feeding Tubes
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Percutaneous Endoscopic<br />
Gastrostomy (PEG)<br />
Gastrostomy <strong>Tubes</strong><br />
PEG Tube<br />
Examples <strong>of</strong> balloon <strong>and</strong> pigtail retained gastrostomy tubes<br />
Balloon Retention – recessed tip<br />
Jejunostomy <strong>Tubes</strong><br />
St<strong>and</strong>ard<br />
Pigtail Retention (modified drainage)<br />
Does not have an external retention mechanism<br />
Low pr<strong>of</strong>ile<br />
19<br />
21<br />
23<br />
Placement<br />
Method<br />
Surgical<br />
Insertion<br />
Laparoscopic<br />
Endoscopic<br />
Radiologic<br />
Enterostomy <strong>Tubes</strong><br />
Remarks<br />
• General anesthesia required; <strong>of</strong>ten as a secondary<br />
procedure during abdominal surgery for another condition<br />
• May have ileus 24 hours post-op; Gastric decompression usually<br />
ordered<br />
• Observe for post-surgical complications<br />
• Monitored conscious sedation; deep sedation or general<br />
anesthesia may be required for some patients<br />
• Less invasive than surgical<br />
• Local anesthesia <strong>and</strong> conscious sedation; requires monitoring<br />
• Popular placement method<br />
• Monitored conscious sedation; does not typically require general<br />
anesthesia<br />
• Least invasive; lower costs <strong>and</strong> risks than other methods<br />
Guenter, P. 2001. Chapter 3. <strong>Enteral</strong> <strong>Feeding</strong> Access Devices, Tube <strong>Feeding</strong>: Practical Guidelines <strong>and</strong> Nursing Protocols; Bowers, S. Dec 2000.<br />
All About tubes, Nursing 30.; Duh, Q. et al. 1999 Laparoscopic Gastrostomy <strong>and</strong> Jejunostomy: Safety <strong>and</strong> cost with Local vs. General Anesthesia.<br />
ARCH SURG 134:151-6.<br />
Low-Pr<strong>of</strong>ile Gastrostomy Devices (LPGDs)<br />
Alternative to traditional gastrostomy or PEG tube<br />
Anchored in the stomach <strong>and</strong> protrudes just above skin<br />
More acceptable cosmetically; affords greater independence<br />
Difficult to dislodge; good choice for children/confused adults<br />
Non-balloon retained Balloon retained<br />
Gastro-Jejunal <strong>Tubes</strong><br />
St<strong>and</strong>ard<br />
Low pr<strong>of</strong>ile<br />
20<br />
22<br />
24
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