Modification of polyurethane to reduce occlusion of enteral feeding tubes

Abstract

Feeding tubes are used to supply nutritional formula to immobilized patients. The most common cause for failure of enteral feeding tubes is their occlusion. The purpose of this study was to examine whether occlusion of enteral feeding tubes could be minimized using an additive. An open, intermittent enteral feeding system was simulated in the laboratory and data were collected over a period ranging from 2 to 6 days. Feeding formula was cycled through a feeding tube in either the presence or absence of simulated gastric acid in an effort to generate a reproducible occlusion. Pressures in the tube were measured frequently throughout these cycles. We observed pressure spikes with each cycle, but never a complete occlusion. Pressure spikes formed only when simulated gastric acid was mixed with the feeding solution. Large amounts of feeding formula adsorbed onto polyurethane (PU) surfaces in the presence of gastric acid. Also, this subtle change in surface chemistry significantly affected the number of pressure spikes observed. The maximum pressure required to maintain flow in the tube was reduced by about half from 2.0 psi to 0.8 psi when polyvinyl alcohol (PVA) was added. The addition of PVA to PU also reduced the contact angle from 83 degrees (untreated) to approximately 64 degrees in the presence of PVA. Furthermore, when formula was added to PU in the presence of PVA the thickness of the layer that remained on the surface was almost 10 times greater in controls than on PVA-treated surfaces. These results suggest that a treatment that increases the hydrophilicity of the feeding tube may help minimize clogging.