Clinical Efficacy and Design Changes of “Fine Bore” Nasogastric Feeding Tubes: A Seven‐Year Experience Involving 809 Intubations in 403 Patients

Abstract

We report here our clinical experiences of "fine bore" nasogastric feeding tubes. Data have been collated over a 7-year period (1978-1985). A total of 403 patients were intubated on 809 occasions. In the first retrospective study, the clinical use of 491 unweighted tubes was compared with that of fifty 3.5-g weighted tubes. No advantage was found in the use of the weighted tubes. In the second prospective controlled clinical trial, these results were confirmed. Forty-six patients were intubated on 76 occasions with an 85-cm open-ended, unweighted nasogastric feeding tube (Prima, Portex UK), and 57 patients were intubated on 79 occasions with a 91-cm 3.0-g weighted tube (Entriflex, Biosearch, Raritan, NJ). Mean duration of placement was similar in each case, and 62% of both types of tubes were inadvertently removed. Without exception, all the tubes remained in the stomach throughout. Disappointed with the similar and overall performance of both types of tubes, we initiated a design program which resulted in the development of two new nasogastric tubes, one weighted and one unweighted. The tubes were manufactured with polyurethane, rather than polyvinylchloride (PVC), which permitted an increase in diameter of the internal lumen which, in turn, was coated with water-activated lubricant to ease removal of the introducer wire. A specially modeled outflow port was incorporated into the tips of both tubes. The performance of the two new polyurethane nasogastric feeding tubes was assessed under controlled trial conditions; as a reference, a widely used PVC unweighted open-ended tube was used.(ABSTRACT TRUNCATED AT 250 WORDS)

Practical Approach to Paediatric Enteral Nutrition: A Comment by the ESPGHAN Committee on Nutrition

“…Complications associated with nasoenteral tubes have become less common since the introduction of fine-bore tubes in the 1970s (67,68). Passage is facilitated using a guidewire, and the tubes are more flexible and less likely to cause erosions, oesophagitis, or strictures.…”

Guidelines for enteral feeding in adult hospital patients

“…Fine bore 5-8 French gauge NG tubes are now used unless there is a need for stomach aspiration, or administration of high fibre feeds or drugs via the tube. 25 Large bore PVC tubes should be avoided as they irritate the nose and oesophagus and increase the risks of gastric reflux and aspiration. They also need frequent replacement as they degrade on contact with gastric contents.…”

Enteral Access Options and Management in the Patient With Intestinal Failure

“…A weighted tip on a nasoenteral tube does not necessarily enable easier transpyloric passage or make proximal displacement less likely. 8 When used solely for delivery of enteral feedings, the smallest diameter tube through which the formula will flow should be used; typically, 8 Fr when an infusion pump is used or 10 Fr if gravity infused. However, these small caliber tubes are more prone to clogging if used to administer medications, decompress the gut, or check gastric residuals.…”