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Dietitians’ Evaluation of Clearing Luminal Occlusions of Gunk (DECLOG): A Pilot Feasibility Study
Author(s) -
Escuro Arlene A.,
Burns Berri,
McLaughlin Kathleen,
Lopez Rocio,
Cresci Gail A.
Publication year - 2020
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1002/ncp.10318
Subject(s) - medicine , occlusion , incidence (geometry) , parenteral nutrition , intubation , enteral administration , surgery , tube (container) , randomized controlled trial , emergency medicine , mechanical engineering , physics , optics , engineering
Background Tube clogging is the most frequent mechanical complication associated with enteral nutrition. The objective of this study was to assess the efficacy of a protocol incorporating prophylactic use of a declogging system with enhanced patient education and monitoring to proactively reduce the incidence of tube occlusions in the home care setting. Methods A convenient sample of patients discharged from hospital to home enteral nutrition (HEN) was screened for eligibility and randomized to control group (standard care) or study group (standard care with prophylactic protocol and monitoring). Study patients received 4 enzyme declogging kits before discharge and were instructed to administer them every 7 days for 4 weeks. Results Seventeen of 49 (35%) patients reported tube occlusions. The incidence of tube occlusion in the control group was not statistically different than in the study group (29% vs 39%, P = 0.44). There was no difference between the 2 groups for negative tube outcomes, such as tube occlusion ( P = 0.44), emergency department visit ( P = 0.24), tube replacement ( P = 0.99), or hospital readmission ( P = 0.33). Continuous feeding method ( P = 0.037), small‐bowel feeding tubes ( P = 0.016), and tube diameter <14 French ( P = 0.069) were associated with tube occlusions. Conclusion A prophylactic protocol using an enzyme declogging system did not lessen the likelihood of tube occlusions when compared with standard care. Multiple factors are associated with tube occlusion. More research investigating the use of a declogging system to prevent clogging incidence in patients receiving HEN is warranted.