FEEDING TUBES IN ENDOSCOPIC AND CLINICAL-PRACTICE - THE LONGER THE BETTER

In an attempt to combine successful distal feeding tube positioning an d a more prolonged stay without interfering with tube patency and feed ing regimens, commercially available 105-cm polyurethane feeding tubes were compared with experimental tubes 125 cm and 145 cm long. The tec hnique for endoscopic positioning at the bedside of the patient was st andardized. Forty-five patients who required intraduodenal or intrajej unal enteral feeding in the intensive care unit were randomly assigned to one of the three tube-length groups. Even the 105-cm short feeding tubes were able to be introduced beyond the duodenojejunal junction, although insufficient tube length remained for tube fixation at the no se. The longer variants, however, were positioned significantly (p < 0 .01) deeper in the intestine, with enough spare tube length for slack formation in the stomach and fixation at the nose. Tubes were elective ly removed in 29% of the patients. Irrespective of tube length, premat ure removal by the patient (in 36%) or by the nurse (in 11%) was rathe r high. Tube blockage was irremediable in 9%. Feeding tubes survived o n average 10.6 days in all three tube-length groups, despite the fact that many drugs were administered by tube as well. The successful, eas y, and fast endoscopic positioning of feeding tubes far into the intes tine and at the patient's bedside may further expand the possibility f or enteral feeding. Moreover, polyurethane materials are well tolerate d, and increasing the tube length does not interfere with tube patency or feeding plans.