PRO's for feeding tubes...please post or respond!

Hi, I am doing a presentation for school about the PRO's (good reasons) for feeding tubes...G-tubes, J-tubes, whatever... I know a lot of us do not like them, (myself included) but I had to take this side of the debate for my presentation, and besides religous articles I've found (the religous aspect of things), I can't find many good reasons for placing them. (I am talking about for the most part, in the elderly and generally unhealthy...NOT young people) If anyone can post a good point about feeding tubes I can bring up in my lecture I would very much appreciate it...also, any stories you have OR resources you know about (be it articles, organizations, etc.) PLEASE share. All responses will be appreciated. Thank you so much guys!!!

:) Kacy

Well, in terms of needing LONG TERM feeding for patient's who've suffered some kind of brain injury and aren't safe to take PO intake d/t risk of aspiration, you can't beat them!

Personally, I don't mind them at all. If you don't like them, it's probably because you haven't worked with them enough to be comfortable with them.

PROs:

1. NG tubes can cause ulcerations in the nasal, esophogeal, etc. tissue after a period of time, so it saves the patient's tissues.

2. They decrease the risk of tube feeding getting into the lungs from improper tube placement.

3. They are more comfortable for the pt. (Once the initial surgical discomfort is over)

4. Again, proper placement!

5. If the patient is not tolerating feedings, the G tube can be converted to a GJ tube....bypassing the stomach.

I'm sure I could think of more...but that's all I came up with right off the top of my head. Granted, they also have con's, but you weren't looking for those, were you?? :)

Well, in terms of needing LONG TERM feeding for patient's who've suffered some kind of brain injury and aren't safe to take PO intake d/t risk of aspiration, you can't beat them!

Personally, I don't mind them at all. If you don't like them, it's probably because you haven't worked with them enough to be comfortable with them.

PROs:

1. NG tubes can cause ulcerations in the nasal, esophogeal, etc. tissue after a period of time, so it saves the patient's tissues.

2. They decrease the risk of tube feeding getting into the lungs from improper tube placement.

3. They are more comfortable for the pt. (Once the initial surgical discomfort is over)

4. Again, proper placement!

5. If the patient is not tolerating feedings, the G tube can be converted to a GJ tube....bypassing the stomach.

I'm sure I could think of more...but that's all I came up with right off the top of my head. Granted, they also have con's, but you weren't looking for those, were you?? :)

We quite often place PEGs in stroke patients who have an impaired but present gag, or when we predict the gag may return. The idea is to minimise the risks of parenteral feeding (as itemised by NeuroICURN) while still meeting the patient's nutritional needs. Sometimes the situation doesn't improve but about half of the time the patients regain enough function to eat, and the PEG is removed.

We quite often place PEGs in stroke patients who have an impaired but present gag, or when we predict the gag may return. The idea is to minimise the risks of parenteral feeding (as itemised by NeuroICURN) while still meeting the patient's nutritional needs. Sometimes the situation doesn't improve but about half of the time the patients regain enough function to eat, and the PEG is removed.

I've seen some patients progress from needing a GT back to po status.

I've seen some patients progress from needing a GT back to po status.

i guess the most obvious pro for me, was to prolong life.

and what are you contrasting the pros with?

other than po, it's the only long term alternative of living, if that's what one wants.

ng tubes are short term only and have much higher risks of aspiration.

but food is considered a pleasure of life, so personally, other than living, i can't think of any advantages.

it's either live or die with(out) nutrition.

i guess the most obvious pro for me, was to prolong life.

and what are you contrasting the pros with?

other than po, it's the only long term alternative of living, if that's what one wants.

ng tubes are short term only and have much higher risks of aspiration.

but food is considered a pleasure of life, so personally, other than living, i can't think of any advantages.

it's either live or die with(out) nutrition.

Is it because uve worked in LTC and seen a lot of tube feeds?

Patients I cared for as a student are still alive because of tube feeds. Comatose, bloated, and forgotten by their families. They will live until they die of something unrelated to their original illness, usually pneumonia.

I knew of one patient as I've described above whose been "alive" 24 years now. Comatose, incontinent, and forgotten.

On the other hand, I've seen geriatric patient have pegs removed and return to a fairly normal diet.

It all depends on the circumstances. Remember once tube feeds are ordered its very difficult to get them discontinued. Even heard MDs say they regret ordering them in some cases.

Is it because uve worked in LTC and seen a lot of tube feeds?

Patients I cared for as a student are still alive because of tube feeds. Comatose, bloated, and forgotten by their families. They will live until they die of something unrelated to their original illness, usually pneumonia.

I knew of one patient as I've described above whose been "alive" 24 years now. Comatose, incontinent, and forgotten.

On the other hand, I've seen geriatric patient have pegs removed and return to a fairly normal diet.

It all depends on the circumstances. Remember once tube feeds are ordered its very difficult to get them discontinued. Even heard MDs say they regret ordering them in some cases.

I used to assist with adult g-tube insertion in radiology. Of all the insertions, I only remember one that made a difference to the life of a patient (as opposed to the existence of the others). I saw him out shopping, he was very pleased with his new way of feeding, if I remember right he had an esophageal fistula, with hx of aspiration pneumonia.