Chapter 34

Nasogastric tubes (NG tubes) and nasojejunal tubes (NJ tubes) can be placed at the bedside or under fluoroscopy. These tubes are used as an initial or temporary feeding tube. Generally, the smallest size enteral tube should be chosen, and the tube should be replaced only when necessary. If long-term feedings are anticipated, tubes should be polyurethane or silicone to reduce the frequency of tube replacement and minimize trauma. Use of weighted tubes should be avoided to decrease the risk of bowel perforation.

Gastrostomy tubes (G tubes), transgastric-jejunal tubes (GJ tube), and jejunal tubes are feeding tubes placed using endoscopic techniques, surgery, or interventional radiology. These types of tubes are used when long-term feeding is necessary. The commonly used enteral feeding devices are summarized in eTable 34.1.

eTable 34.1. Enteral Feeding Device Selection

Gastrostomy tubes are commonly used in patients who require prolonged enteral nutritional support. Some patients can tolerate prolonged use of nasogastric feedings and avoid a gastrostomy; however, patients who will require tube feedings for more than 2 to 3 months should be considered for gastrostomy tube placement to avoid complications and trauma with the replacement of nasogastric tubes.1 This is particularly important with infants and young children, who may develop a severe feeding aversion exacerbated by nasogastric tube irritation of the nasal passages and oropharynx. Placement of a gastrostomy tube will facilitate progression of oromotor development in some of these children ...

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