Accuracy of Water Delivery in Enteral Nutrition Pumps. 2021

Erin J Bertagnolli, and Mindy A Patterson, and Anne Utech, and Renee N Walker
Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.

BACKGROUND Adequate delivery of both enteral formula and water in patients receiving enteral nutrition (EN) is critical. Pump accuracy has been identified as a factor impeding enteral formula delivery; however, rarely is enteral water delivery investigated. The purpose of this study was to explore accuracy of delivering 1 L of water by EN pumps using different flush volumes and hang heights. METHODS Three EN pumps were used in vitro to flush 1 L of water at 50 mL every hour for 20 hours (50 mL, 20 times per day) and 500 mL every 4 hours for 8 hours (500 mL, 2 times per day) at 0 in. and 18 in. (or 45.72 cm) hang heights. Fifteen runs were conducted at each volume and hang height per pump. Actual delivered enteral water, remaining volume in enteral feeding bags, and volume reported per pump were recorded. RESULTS Hang height of 18 in. delivered a mean 3.91% (95% CI, 3.25-4.57) more water than bags hung at 0 in. (P < .0005). When delivering water in 500 mL increments, 1.57% (95% CI, 0.92-2.23) more water was delivered than when delivered in 50 mL increments (P < .005). CONCLUSIONS Appropriate hang height recommendations improve enteral water delivery in patients receiving EN. The most accurate setting was 500 mL at 18 in., resulting in accurate water delivery in 97.8% of runs, whereas 50 mL at 0 in. delivered accurately 17.8% of the time. Appropriate bag hang height and water delivery volume is critical to maintain hydration status of patients receiving EN.

UI MeSH Term Description Entries
D004750 Enteral Nutrition Nutritional support given via the alimentary canal or any route connected to the gastrointestinal system (i.e., the enteral route). This includes oral feeding, sip feeding, and tube feeding using nasogastric, gastrostomy, and jejunostomy tubes. Enteral Feeding,Force Feeding,Nutrition, Enteral,Tube Feeding,Gastric Feeding Tubes,Feeding Tube, Gastric,Feeding Tubes, Gastric,Feeding, Enteral,Feeding, Force,Feeding, Tube,Feedings, Force,Force Feedings,Gastric Feeding Tube,Tube, Gastric Feeding,Tubes, Gastric Feeding
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014867 Water A clear, odorless, tasteless liquid that is essential for most animal and plant life and is an excellent solvent for many substances. The chemical formula is hydrogen oxide (H2O). (McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed) Hydrogen Oxide
D016638 Critical Illness A disease or state in which death is possible or imminent. Critically Ill,Critical Illnesses,Illness, Critical,Illnesses, Critical

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