Self-insertion of a nasogastric tube for home enteral nutrition: a pilot study

JPEN J Parenter Enteral Nutr. 2014 Sep;38(7):895-900. doi: 10.1177/0148607113502544. Epub 2013 Oct 18.

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.

Keywords: enteral tube feeding; home enteral nutrition; self-insertion of nasogastric tube; self-management; therapeutic patient education.

MeSH terms

  • Abdominal Pain / etiology
  • Adult
  • Deglutition Disorders / etiology
  • Enteral Nutrition / adverse effects
  • Enteral Nutrition / methods*
  • Female
  • Humans
  • Intubation, Gastrointestinal / adverse effects
  • Intubation, Gastrointestinal / methods*
  • Male
  • Nausea / etiology
  • Patient Satisfaction
  • Pilot Projects
  • Self Care* / adverse effects