Didier Quilliot1, Camille Zallot2, Aurélie Malgras3, Adeline Germain4, Laurent Bresler5, Ahmet Ayav4, Marc-André Bigard6, Laurent Peyrin-Biroulet2, Olivier Ziegler7. 1. Department of Nutrition, Nancy University Hospital, Vandoeuvre-les-Nancy, France INSERM U954, Medical Faculty and CHU of Nancy, Vandoeuvre-les-Nancy, France d.quilliot@chu-nancy.fr. 2. INSERM U954, Medical Faculty and CHU of Nancy, Vandoeuvre-les-Nancy, France Department of Gastroenterology, Nancy University Hospital, Vandoeuvre-les-Nancy, France. 3. Department of Nutrition, Nancy University Hospital, Vandoeuvre-les-Nancy, France. 4. INSERM U954, Medical Faculty and CHU of Nancy, Vandoeuvre-les-Nancy, France Department of Hepatobiliary, Digestive and Endocrine Surgery, Nancy University Hospital, Vandoeuvre-les-Nancy, France. 5. Department of Hepatobiliary, Digestive and Endocrine Surgery, Nancy University Hospital, Vandoeuvre-les-Nancy, France. 6. Department of Gastroenterology, Nancy University Hospital, Vandoeuvre-les-Nancy, France. 7. Department of Nutrition, Nancy University Hospital, Vandoeuvre-les-Nancy, France INSERM U954, Medical Faculty and CHU of Nancy, Vandoeuvre-les-Nancy, France.
Abstract
BACKGROUND: Enteral tube feeding can be a source of discomfort and reluctance from patients. We evaluated for the first time the tolerability of self-insertion of a nasogastric (NG) tube for home enteral nutrition (EN). MATERIALS AND METHODS: All patients requiring enteral tube feeding for chronic diseases were enrolled in a therapeutic patient education (TPE) program at Nancy University Hospital. RESULTS: In our department, between November 2008 and August 2012, 66 patients received EN with an NG tube. Twenty-nine of 66 had self-insertion of the NG tube (median age, 44 years), 17 had an anatomical contraindication, and 20 were excluded because of cognitive disability or language barrier or refusal. Twenty-eight of 29 patients completed the TPE program. One patient died of pancreatic cancer in palliative care during the study. Median follow-up was 20 months (interquartile range [IQR], 4-31). Median gain weight was 3.1 kg (IQR, 1.8-6.0) (P = .0002). Median duration of self-insertion of the NG tube was 3 months (IQR, 2-5), and it was well tolerated by all 29 patients. Two patients described minor adverse events: abdominal pain and nausea for 1 patient and epistaxis leading to temporary discontinuation of EN for another patient. A group of 10 consecutive patients previously had a long-term NG tube for EN. If they had the choice between a self-inserted NG tube and a long-term NG tube, all 10 patients reported they would prefer to start again with the self-inserted NG tube. CONCLUSION: This pilot study suggests that self-insertion of an NG tube may be efficacious and well tolerated in patients receiving EN for chronic conditions.
BACKGROUND: Enteral tube feeding can be a source of discomfort and reluctance from patients. We evaluated for the first time the tolerability of self-insertion of a nasogastric (NG) tube for home enteral nutrition (EN). MATERIALS AND METHODS: All patients requiring enteral tube feeding for chronic diseases were enrolled in a therapeutic patient education (TPE) program at Nancy University Hospital. RESULTS: In our department, between November 2008 and August 2012, 66 patients received EN with an NG tube. Twenty-nine of 66 had self-insertion of the NG tube (median age, 44 years), 17 had an anatomical contraindication, and 20 were excluded because of cognitive disability or language barrier or refusal. Twenty-eight of 29 patients completed the TPE program. One patient died of pancreatic cancer in palliative care during the study. Median follow-up was 20 months (interquartile range [IQR], 4-31). Median gain weight was 3.1 kg (IQR, 1.8-6.0) (P = .0002). Median duration of self-insertion of the NG tube was 3 months (IQR, 2-5), and it was well tolerated by all 29 patients. Two patients described minor adverse events: abdominal pain and nausea for 1 patient and epistaxis leading to temporary discontinuation of EN for another patient. A group of 10 consecutive patients previously had a long-term NG tube for EN. If they had the choice between a self-inserted NG tube and a long-term NG tube, all 10 patients reported they would prefer to start again with the self-inserted NG tube. CONCLUSION: This pilot study suggests that self-insertion of an NG tube may be efficacious and well tolerated in patients receiving EN for chronic conditions.