Enteral Feeding Tube
Field of the inven tion
The present invention relates to an enteral feeding tube.
Background to the inventton
Adequate nutrition and medication are of key importance in patient recovery. In patients who are unable to swallow or take adequate nutrition or medication orally, a nasogastric, nasojejuna! or nasoduodenal feeding tube is often used to deliver nutrients or medication directly into the gastrointestinal tract. Enteral feeding has few complications and is low cost compared with parenteral nutrition which is associated with a high complication rate and high cost.
If the patient has a functioning gastrointestinal tract, the feeding tube is inserted through the nose into the stomach or small intestine via the pharynx and oesophagus. Correct positioning of the feeding tube is verified by aspirating gastric juice which is tested using pH paper. The patient can then receive nutrition via the feeding tube.
A known feeding tube has an outlet port in a rigid bolus which is larger than the
French gauge of the feeding tube (see for example US-A-6511474). The rigidity of the bolus increases the risk of lung puncture during placement. The distal end of the rigid bolus includes an aperture that forms a stylet passage. As the aperture is dimensioned for receipt of a stylet, fluid flow is restricted due to the narrowness of the aperture. Instead, fluid flows through a fluid opening within the sidewall of the bolus.
The present invention seeks to improve the performance of a feeding tube by at least improving the rate of fluid flow, reducing the amount of dead space within the feeding tube which can lead to blockages and, providing an atraumatic tip.
Summary of the invention
According to a first aspect of the invention there is provided an enteral feeding tube for administration and aspiration of fluids within a gastrointestinal tract of a subject, the enteral feeding tube comprising:
-2a hollow tube, comprising a wall member, a proximal end configured for connection to a fluid source, and a distal end, wherein at least one fluid discharge port is passing through the wall member, and a cap comprising a proximal end configured for connection with the distal end of the hollow tube, a generally rounded distal end, and a fluid conduit extending between the proximal end of the cap and the generally rounded distal end of the cap.
In some constructions of the feeding tube, a diameter of the fluid conduit at the distal end of the cap is substantially the same or greater than an internal diameter of the hollow tube.
In order to further reduce the risk of the hollow tube becoming occluded with mucous, gastrointestinal debris or coagulated feeding material, the hollow tube includes at least two fluid discharge ports that passes through the wall member.
When attempting to place a nasogastric enteral tube, the test to determine whether the tube is in the correct location is the aspiration and pH testing of gastric fluid.
When only one fluid outlet port is provided through the wall member of the hollow tube, there is a risk that the pressure created during the aspiration process could cause the hollow tube to suction onto a surface or organ within the body, potentially damaging it. Having at least two fluid discharge ports reduces the possibility of suction attachment to an internal surface during aspiration.
Optionally, the wall member of the hollow tube includes an anterior portion and a posterior portion and at least a first fluid discharge port is disposed at least partially within the anterior portion of the wall member, and at least second fluid discharge port is disposed at least partially within the posterior portion of the wall member.
In some constructions, at least the first fluid discharge port and at least the second fluid discharge port are disposed on opposing sides of the wall member of the hollow tube. This means that there is even less chance of the hollow tube becoming attached to an internal surface or organ during aspiration, as the hole on the opposite side would release the pressure, preventing damage. Additionally, the presence of the
-3fkiid discharge ports on the hollow tube facilitates the dissipation of fluid from the enteral feeding tube.
The feeding tube according to any of the constructions described herein may have a proximal connection end of the cap that includes a cylindrical boss dimensioned for receipt within the distal end of the hollow tube. The hollow tube and cap may be secured together by adhesive.
In some constructions, the distance between a distal edge of the most distally placed fluid discharge port and the proximal end of the cap is in the range of about 0.5 mm and 1.5 mm.
In particular constructions, the distance between the distal edge of the most distally placed fluid discharge port and the proximal end of the cap is in the range of about 0.7mm and 1.3 mm. More particularly, the distance is about 1 mm. The distance may varying within design tolerances.
The generally rounded distal end of the cap provides an atraumatic tip. The rounded tip provides less resistance during intubation. This minimises any damage to the soft tissue during insertion of the feeding tube. In some constructions, the generally rounded distal end also includes a flattened tip. This reduces the risk of snagging of soft tissue on distal end of the cap, and occlusion of the fluid conduit.
Advantageously, at least a part of the cap is radiopaque. This allows medical personnel to visualise the progress of the feeding tube, via an x-ray monitor, as the tube is guided through the nose into position, and to also verify the final placement of the feeding tube.
The enteral feeding tube may be a nasogastric feeding tube, a nasojejunal feeding tube or a nasoduodenal feeding tube.
In some applications, the enteral feeding tube is introduced into the gastrointestinal tract in an over-the-wire intubation procedure. A wire stylet, or guide wire may extend through the hollow tube, via the fluid passage of the cap, and exit through the distal end of the cap. The guide wire is used to guide the feeding tube to a location that may be more difficult to reach, such as the jejunum (i.e., the middle portion of the small intestine, between the duodenum and the ileum) or duodenum. The guide wire is inserted ahead of the cap to a desired position. The feeding tube is then slipped over the wire and advanced to the desired position. When the enteral feeding tube is properly placed, 5 the wire is removed.
According to a second aspect of the invention, there is providing a method for the administration and aspiration of fluids within the gastrointestinal tract which comprises the step of inserting the feeding tube according to the first aspect of the invention into a patient.
1° Brief Description of the Figures
Constructions of the present invention will be described hereinafter, by way of example only, with reference to the accompanying drawings in which like reference signs relate to like elements and in which:
Figure 1 illustrates a perspective view of the feeding tube of the invention;
Figure 2 illustrates a side view of at least a part of the feeding tube shown in
Figure 1.
Detailed Description of the Figures
An illustrative feeding tube according to the invention is shown in Figs. 1 and 2.
The feeding tube 10 includes a hollow tube 12 comprising a wall member 14, a proximal end 16 configured for connection to a fluid source (e.g. nutrient supply) and a distal end 18. In the construction shown, a first fluid discharge port 20 passes through the wall member and a more proximally located second discharge port 22 passes through the wall member. The first fluid discharge port 20 and the second fluid discharge port 22 are disposed about the wall member in a staggered arrangement.
The first fluid discharge port 20 has a distal edge 24.
-5The feeding tube 10 also includes a cap 26. The cap has a proximal end 28 configured for connection with the distal end 18 of the hollow tube.
In the construction shown, the proximal end 28 of the cap includes a cylindrical boss 32 that is dimensioned for receipt within the distal end 18 of the hollow tube. The cap may be secured to the hollow tube by various means known to the skilled person, including an adhesive.
The distance between the distal edge 24 of fluid discharge port 20 and the proximal end 28 of the cap 26 is in the range of about 0.5 mm and 1.5 mm.
In particular constructions, the distance between the distal edge 24 of the fluid 10 discharge port 20 and the proximal end 28 of the cap 26 is in the range of about 0.7 mm and 1.3 mm. More particularly, the distance is about 1 mm.
Although nasogastric tubes are available in a range of different lengths, the distance between the proximal end of the cap, and the most distally placed fluid port is constant. The distance remains the same (e.g., approximately 1 mm) across a range of 15 lengths of tube.
The cap also has a distal end 34. In order to provide an atraumatic tip, the distal end of the cap is generally rounded. The distal end may also have a flattened tip 36.
As shown in Figure 2, the cap includes a fluid conduit 38 that extends between the proximal end 28 of the cap and the distal end 34 of the cap. In order to provide a high 20 fluid flow through the enteral tube, the diameter (diami) of the fluid conduit 38 at least at the distal end 34 of the cap is the same or greater than an internal diameter (diairu) of the hollow tube.
As shown in Figure 2, the diameter of the fluid conduit 38 within the cap is narrower that the internal diameter of the hollow tube within the cylindrical boss 32 25 section. The diameter of the fluid conduit within the cap then increases through a flared transition section 40 to reach the same diameter as that of the internal diameter of the hollow tube. This ensure high fluid flow.
-6Although a particular construction of the invention has been described, it will be appreciated that many modifications/additions and/or substitutions may be made within the scope of the claimed invention.