enteral nutrition devices

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Presentation Description

Dr John Thanakumar Senior Surgeon, Minimal Access, Bariatric and GI Surgery Global Hospital, Chennai. Discussion of the enteral nutritional devices with description of nasto gatric, PEG and jejunostomies for feeding.

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Presentation Transcript

Enteral Nutrition Devices:

Enteral Nutrition Devices Dr John AC Thanakumar FRCS, FRCS, MS, MNAMS, Dip MIS Bariatric, Minimal Access & GI Surgeon Global Hospital, Chennai

Slide 2:

A feeding tube is a device used to provide nutrition to patients who cannot obtain nutrition by swallowing by a normal orifice or using percutaneous method.

Slide 3:

The state of being fed by a feeding tube is called  enteral feeding or tube feeding.

Type of Tube:

Type of Tube Placement may be temporary acute conditions or lifelong in chronic conditions.

Feeding Tubes -General:

Feeding Tubes -General A variety of feeding tubes are used in medical practice. They are usually made of polyurethane or silicone. The diameter of a feeding tube is measured in French units (each French unit equals 0.33 millimeters).

Classification:

Classification They are classified by site of insertion and intended use.

Nasogastric :

Nasogastric A nasogastric tube, or NG-tube, is passed through the nostril via the esophagus into the stomach. Nasogastric feeding tube is generally used for short term feeding, usually only 2 weeks maximum.

Naso gastric Tube:

Naso gastric Tube

Gastric tube:

Gastric tube A gastric feeding tube is a tube into the stomach inserted via a small abdominal incision and is used for long-term enteral nutrition.

PEG steps:

PEG steps Endoscope the stomach and light seen from exterior. A needle is percutaneously and visalized via the scope. Suture is passed through the needle is grasped by the endoscope and pulled up via the esophagus.

PEG- Steps:

PEG- Steps Suture is tied to the end of the PEG tube , pulled down through the esophagus, stomach, and out through the abdominal wall. The procedure under local anesthesia takes about 30 minutes. The tube is kept retained in the stomach by a balloon on its tip or by a retention dome

PEG tube:

PEG tube

When to use Gastric Tube:

When to use Gastric Tube Gastric feeding tubes are for long-term Pharyngeal reflux should be present for the use Neurological disorders like stroke Part of an operation like esophageal atresia Pdvanced dementia Palliation for advanced cancer

Jejunostomy:

14 Jejunostomy Is usually part of another operation Can be done by open or laparoscopic surgery as well as endoscopy Useful in absent pharyngeal reflux Two methods- Stamm & Witziel 14

Fluids for administration:

15 Fluids for administration Formula feeds are thin and it is easy to calculate the calories Formula feed are thinner and do not clog Blendarized diet are cheaper but tend to clog the tube 15

Complications:

Complications Complication 1%. Peritonitis due to leak. The most frequent complication is irritation around thetube Patients can dislodge the feeding tubes requiring a hospitalization to replace Clogging of tubes Migration

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