Self‐Insertion of a Nasogastric Tube for Home Enteral Nutrition |
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Authors: | Didier Quilliot MD PhD Camille Zallot MD Aurélie Malgras MD Adeline Germain MD Laurent Bresler MD PhD Ahmet Ayav MD PhD Marc‐André Bigard MD PhD Laurent Peyrin‐Biroulet MD PhD Olivier Ziegler MD PhD |
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Institution: | 1. Department of Nutrition, Nancy University Hospital, Vandoeuvre‐les‐Nancy, France;2. INSERM U954, Medical Faculty and CHU of Nancy, Vandoeuvre‐les‐Nancy, France;3. Department of Gastroenterology, Nancy University Hospital, Vandoeuvre‐les‐Nancy, France;4. Department of Hepatobiliary, Digestive and Endocrine Surgery, Nancy University Hospital, Vandoeuvre‐les‐Nancy, France |
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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. |
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Keywords: | enteral tube feeding self‐insertion of nasogastric tube self‐management home enteral nutrition therapeutic patient education |
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