GI Tubes

Tube Feeding

Tube Feeding Calculator

general

Tube food concentrations:

• between 1.0 and 2.0 kCal / mL
  More concentrated:
  • less volume needed for daily kCal needs
  • more free water needed
    Less concentrated:
  • more volume needed for daily kCal needs
  • less free water needed

tube food math

Daily Caloric goal= Weight (kg) x 25

• min protein goal = 1g/kg
• supplement: prostat

Qty of tube food = Daily caloric goal /tube food concentration

• i.e. 2500kCal / 1.5 =1,667 mL of tube food

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water math

Tube feeds are 75% water

• Daily water requirement = 1mL per Kcal of tube feed

• Tube food volume x 0.75 = tube food water

• Daily water requirement - tube food water = free water need

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tube mechanics

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feeding rate

Gastric feeds:

• i.e. NG tube, PEG, etc.
• Stomach can accommodate larger boluses of food
• “Can” sized amounts divide “meals”

Small bowel feeds:

• i.e. Dobhoff, DJ tube, etc.
• duodenum/jejunum cannot accommodate large boluses
• MUST PUT TUBE FOOD ON PUMP
• rate = daily food (mL) / hours of feeding

Tube Types

nasogastric tubes (NGT)

Common uses:

• gastric decompression (SBO, ileus, gastroparesis)
• NPO patients
• placed on LIWS (low intermittent wall suction)

Daily gastric juice production = 1-1.5L / day

• NGT output dictates when it can be pulled
• used to measure how much content is transiting the GI tract

NGT Daily Output

• <500mL = good to pull
• 500-1000mL = iffy
• more than 1L = keep it in
  Another method: 4hr clamp trial
• is pt tolerates (no nausea, vomit, burp, belch, hiccup, etc) then probably ok to pull
• risks:

gastrojejunal tubes (GJT)

• 2 lumens: feeds stomach and jejunum
• Placed by GI, IR, or intraoperative
• G tube
  • can vent gastric contents while still feeding patient through J
  • can perform clamping trials
• J tube
  • can feed distal to reconstruction edema