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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.
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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.
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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 ...