Abstract
[Purpose] We have been proposing the hypothesis of the mechanism of EN catheter obstruction. The first step is the intestinal bacteria proliferation in the enteral formula and consequent PH decrease at the tip of EN catheter. Protein in the formula is degenerated and the formula is going to solidified as the curd. This is the sequential story of the obstruction. We think the fluidity of the enteral formula is not related with the obstruction of the catheter. The purpose of this study is the verification of this hypothesis using the acidic enteral formula with less fluidity, “Fibren YH®”.
[Methods and Materials] 1) The basic experiment of bacterial contamination and solidification of the enteral formula: Escherichia coli, Enterococcus faecalis, Klebsiella pneumoniae ware administrated in 3 usual type formulas and Fibren YH, and cultured. 2) The clinical study of the EN catheter obstruction: Continuous EN was applied to the surgical patients using the jejunostomy, and observed the event of the catheter obstruction.
[Results] 1) 3 usual formulas showed the proliferation of the bacteria as 100 folds and PH decrease, while Fibren YH showed the decrease of the number of bacteria. 3 usual formulas were solidified but Fibren YH was left as fluid during the observation period. 2) 89% (8/9) of the patients who received the usual type formula showed the catheter obstruction, while none of the patients (0/10) who received Fibren YH showed the obstruction.
[Conclusion] This study showed the bacterial proliferation and the consequent solidification of the enteral formula is the reason of the obstruction of the EN catheter. FibrenYH is unlikely to obstruct the catheter.
