Clogs and Clots in Enteral Tubes: Prevention and Treatment

Abstract

Patients in the critical care unit often receive nutrition through enteral access. A common complication of enteral nutrition is the occlusion of the enteral tube. This complication occurs at a rate as high as 35 %. A clog that cannot be dissolved may require replacement of the enteral tube, which increases the risk of adverse outcomes and cost. To prevent this complication critical care practitioners should be diligent in recognizing risk factors and using best practice to help prevent an occlusion from forming. Some of the risk factors of enteral occlusion include contact of enteral nutrition with acidic fluid, intact protein and high-fiber formulations, improper administration of medications, and slowing or stopping the flow of enteral nutrition. Prevention is of utmost importance in maintaining enteral tube patency and includes proper tube feed flushing with sterile water. When treatment is required for an occluded tube, warmwater flushes are the first-line agent to restore patency. Second-line therapy includes activated pancreatic enzyme solution. When all treatment options have failed, replacement of the enteral tube is necessary.