Enteral Tube Feeding Algorithm
Enteral Tube Feeding Algorithm Tube Feeding: Routes and Complications Tube Feeding: Routes and Complications
«Flowchart»

Inadequate growth on oral caloric intake
(physician or registered dietitian consultation)

Inadequate growth on oral caloric intake
(physician or registered dietitian consultation)

Inadequate growth on oral caloric intake
(physician or registered dietitian consultation)

Inadequate growth on oral caloric intake

While etiology being determined, if available, get evaluation by speech pathologist to determine presence of oral dysphagia

While etiology being determined, if available, get evaluation by speech pathologist to determine presence of oral dysphagia

While etiology being determined, if available, get evaluation by speech pathologist to determine presence of oral dysphagia

No oral dysphagia

No oral dysphagia

No oral dysphagia

Oral dysphagia

Oral dysphagia

Oral dysphagia

Trial oral formula supplementation

Trial oral formula supplementation

Trial oral formula supplementation

Unsuccessful

Unsuccessful

Unsuccessful

End

End

End

Long term needs (.3 months): switch to gastrojejunostomy tube vs. GT 1 Nissen fundoplication vs. jejunostomy tube†

Long term needs (.3 months): switch to gastrojejunostomy tube vs. GT 1 Nissen fundoplication vs. jejunostomy tube†

Long term needs (.3 months): switch to gastrojejunostomy tube vs. GT 1 Nissen fundoplication vs. jejunostomy tube†

Tolerated

Tolerated

Tolerated

Short term (,3 months): keep NG

Short term (,3 months): keep NG

Short term (,3 months): keep NG

Long term needs (.3 months): switch to gastrostomy tube 1/2 Nissen fundoplication based on aspiration risk^

Long term needs (.3 months): switch to gastrostomy tube 1/2 Nissen fundoplication based on aspiration risk^

Long term needs (.3 months): switch to gastrostomy tube 1/2 Nissen fundoplication based on aspiration risk^

Trial formula supplementation via NG tube

Trial formula supplementation via NG tube

Trial formula supplementation via NG tube

Tolerated

Tolerated

Tolerated

Significant vomiting observed

Significant vomiting observed

Significant vomiting observed

Short term (<3 months): keep NG

Short term (<3 months): keep NG

Short term (<3 months): keep NG

Long term needs (>3 months): switch to gastrostomy tube 1/2 Nissen fundoplication based on aspiration risk^

Long term needs (>3 months): switch to gastrostomy tube 1/2 Nissen fundoplication based on aspiration risk^

Long term needs (>3 months): switch to gastrostomy tube 1/2 Nissen fundoplication based on aspiration risk^

Consider PN and consult GI specialist

Consider PN and consult GI specialist

Consider PN and consult GI specialist

Consider gastric emptying scan vs. trial of NJ tube

Consider gastric emptying scan vs. trial of NJ tube

Consider gastric emptying scan vs. trial of NJ tube

Tolerated

Tolerated

Tolerated

Significant diarrhea or pain observed

Significant diarrhea or pain observed

Significant diarrhea or pain observed

Short term (<3 months): keep NJ

Short term (<3 months): keep NJ

Short term (<3 months): keep NJ

Long term needs (>3 months): switch to gastrojejunostomy tube vs. GT 1 Nissen fundoplication vs. jejunostomy tube†

Long term needs (>3 months): switch to gastrojejunostomy tube vs. GT 1 Nissen fundoplication vs. jejunostomy tube†

Long term needs (>3 months): switch to gastrojejunostomy tube vs. GT 1 Nissen fundoplication vs. jejunostomy tube†