Yes. I did remove the pt's MIC-Key button for one day. The pt does not have prune belly syndrome, but her abdominal muscles are hypotonic. In addition, she has a history of button displacement which further complicated the issue. At our facility, if the pediatric team also agrees, the order is placed and the button removed for the specified period of time so that the musculature can contract with the hope that leakage can be resolved. However, in this instance (and this is why I posted my question), the pt's issue has not been resolved by this method. The pt continues to leak formula from her site.
As to the question regarding nutrition, this pt had leaked a significant enough amount of formula to cause her electrolytes to be off. As a result, I recommended (and the team agreed) to have an NJ tube placed, and the button removed. There was still some drainage, but not nearly as much. I returned 24 hours later and reinserted the button with no difficulty. At first, there was no drainage and I had hoped the issue was fixed. Now, though, the drainage has started again. The other potential option is a MIC Key GJ - but the patient is still likely to leak non-formula gastric contents from the site. While likely not as much, I would still be concerned about electrolyte imbalances.
Rivernurse
