Background: Alkalinized Viokase pancreatic enzyme tablets restored patency to 71.9% of occluded Dobhoff tubes in a prospective study. After removal of Viokase tablets from the US market, the hospital protocol for unclogging enteral feeding tubes was adapted to use Creon pancreatic enzyme delayed-release capsules, despite the lack of published data.
Objective: To evaluate the effectiveness of a Creon-based protocol to clear occluded enteral feeding tubes.
Methods: This retrospective study included all adult and pediatric patients seen in the emergency department or in an inpatient setting who received Creon 12 000 units lipase delayed-release capsule dissolved in a solution of sodium bicarbonate 650 mg and sterile water for clearing occluded enteral feeding tubes between May 1 and November 30, 2010. The Creon protocol was deemed effective if tube clearance was documented in the medical record or if enteral feedings were resumed with no note regarding tube replacement.
Results: Alkalinized Creon delayed-release capsules were administered to 83 patients with a total of 118 clogged tubes. Three poorly documented cases and 5 tubes with mechanical clogs were excluded from data analysis. Patency was restored to 53 of 110 (48.2%) occluded tubes. More than 1 treatment course was attempted in 5 cases, with success in 3.
Conclusion: An alkalinized Creon pancreatic enzyme protocol was effective in clearing approximately half of the occluded enteral feeding tubes in this retrospective study, an efficacy rate much less than that previously reported in the literature with a Viokase-based protocol.
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http://dx.doi.org/10.1177/1060028013515435 | DOI Listing |
BMC Gastroenterol
December 2024
Division of Gastroenterology, Department of Medicine, BronxCare Health System, Clinical Affiliate of Mt Sinai Health Systems and Academic Affiliate of Icahn School of Medicine, 10C, 1650 Selwyn Avenue, Bronx, NY, 10457, USA.
Background: Percutaneous Endoscopic Gastrostomy (PEG) tube insertion, a routine procedure for long-term enteral nutrition, serves as a crucial intervention for patients who are incapable of tolerating oral intake or meeting adequate nutritional requirements. PEG tube placement carries complications like bleeding and infection. Impact of PEG tubes on the 30-day and long-term mortality in HIV patients is unknown.
View Article and Find Full Text PDFJ Pediatr Surg
December 2024
Department of Surgery, Boston Children's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address:
Purpose: Anastomotic ulcers (AUs) are a rare cause of morbidity in intestinal failure (IF). Prior studies of AUs have been small, descriptive reports. We evaluated a large cohort of IF patients to identify risk factors and describe treatment strategies for AUs.
View Article and Find Full Text PDFAm J Crit Care
January 2025
Mary Lou Sole is dean, professor, and Orlando Health Endowed Chair in Nursing, University of Central Florida College of Nursing, Orlando.
Background: Enteral feeding intolerance, a common type of gastrointestinal dysfunction leading to underfeeding, is associated with increased mortality. Tracheal pepsin A, an indicator of microaspiration, was found in 39% of patients within 24 hours of enteral feeding. Tracheal pepsin A is a potential biomarker of enteral feeding intolerance.
View Article and Find Full Text PDFIn Vivo
December 2024
Department of Surgery, Clinical Center, Medical School, University of Pécs, Pécs, Hungary.
Background/aim: Enhanced recovery after surgery (ERAS) protocol is adopted in clinical practice worldwide, but a lack of evidence for measurable benefits after upper gastrointestinal (GI) surgeries can be detected especially regarding early oral feeding.
Patients And Methods: A propensity score-matching study was conducted at the Department of Surgery of the University of Pécs between January 2020 and December 2023. The study included patients who underwent upper GI cancer surgery and were treated according to an early oral feeding protocol (EOF).
Int J Surg Case Rep
December 2024
Faculty of Health, Universidad Santiago de Cali, Cali, Colombia. Electronic address:
Introduction: Metabolic acidosis, marked by decreased plasma bicarbonate and arterial pH, is a common complication following extensive abdominal surgeries. D-lactate acidosis presents additional diagnostic challenges due to nonspecific symptoms.
Presentation Of Case: A 65-year-old woman with hypertension and morbid obesity was admitted to the ICU for intestinal obstruction and peritonitis due to an incarcerated hernia.
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