Name of the Procedure:

• Common Name(s): Enteral Nutrition, Tube Feeding
• Technical/Medical Term: Enteral Formula, Manufactured Blenderized Natural Foods (B4149)

Summary

Enteral formula administered through a feeding tube to provide nutrition when oral intake is inadequate or not possible. This formula includes a blend of natural foods with intact nutrients such as proteins, fats, carbohydrates, vitamins, and minerals, and may also include fiber. Each unit equates to 100 calories.

Purpose

Medical Conditions Addressed:

• Malnutrition
• Severe dysphagia (difficulty swallowing)

• Chronic conditions affecting nutrient intake (e.g., cancer, neurological diseases)

  Goals/Expected Outcomes:

• Ensure adequate nutritional intake
• Support growth and development
• Maintain or improve physical health and energy levels

Indications

Symptoms/Conditions Warranting the Procedure:

• Inability to consume sufficient calories orally
• Severe gastrointestinal disorders limiting nutrient absorption

• Post-operative need for nutrition support

  Patient Criteria:

• Patients needing long-term or short-term nutritional support
• Inability to maintain a healthy weight via oral diet

Preparation

Pre-Procedure Instructions:

• Review medical history and current medications with healthcare provider
• Possibly fasting if starting tube feeding post-operatively

Diagnostic Tests/Assessments:

• Nutritional assessment
• Placement verification of the enteral feeding tube

Procedure Description

1. Preparation:
   • Ensure the feeding tube is properly placed and verified.
   • Gather the enteral formula and all necessary equipment (feeding bags, pump if required).
2. Administration:
   • Connect the enteral formula to the feeding tube.
   • Set the feeding rate on a pump, or employ gravity feeding as per the medical provider's instructions.
3. Monitoring:
   • Observe for any signs of discomfort, intolerance, or complications during feeding.
4. Clean-Up:
   • Flush the feeding tube with water post-feeding to prevent blockage.

Tools/Equipment:

• Enteral feeding tube, feeding pump or gravity bags, sterile water for flushing

Anesthesia/Sedation:

• Not typically required for the feeding procedure itself

Duration

• Enteral feeding sessions' duration varies based on the feeding method and patient tolerance, typically ranging from 30 minutes to a few hours.

Setting

• Can be performed in various settings including hospitals, outpatient clinics, long-term care facilities, or at home.

Personnel

• Registered Dietitian
• Nurse or trained caregiver
• Physician overseeing care

Risks and Complications

Common Risks:

• Gastrointestinal discomfort

• Tube blockage

  Rare Risks:

• Aspiration pneumonia
• Infection at the tube site

Possible Complications:

• Managed by adjusting the formula type or feeding rate, ensuring tube hygiene and proper placement.

Benefits

Expected Benefits:

• Improved nutritional status
• Increased energy levels
• Enhanced quality of life

Timeframe:

• Patients may start seeing benefits within days to a few weeks, depending on their initial nutritional status.

Recovery

Post-Procedure Care:

• Regular monitoring of weight and nutritional intake
• Daily care of the feeding tube site

Recovery Time:

• Varies per individual; continuous monitoring required

Restrictions/Follow-Up:

• Regular follow-up appointments to assess nutritional needs and tube function.

Alternatives

Other Treatment Options:

• Oral nutritional supplements
• Intravenous (parenteral) nutrition

Pros and Cons of Alternatives:

• Oral supplements can be less invasive but may not be sufficient for all patients.
• Parenteral nutrition can be used when enteral feeding is not possible but is more invasive and requires closer monitoring.

Patient Experience

What to Feel/Experience:

• Some initial discomfort with tube placement
• Potential bloating or digestive adjustments as feeding begins

Pain Management and Comfort Measures:

• Good pain management strategies should be in place, particularly during initial placement and adjustment periods.
• Ensuring a gradual increase in feeding rate can enhance comfort.