NO tube stands for naso-oesophageal. It is a feeding tube that provides short term enteral, nutritional support. It is ideal in patients where sedation or anaesthetic is contra-indicated.
Advantages
- Well tolerated
- Non-invasive
- Does not prevent the animal from eating and drinking
- Easy to place
- Suitable for very ill patients
- Can be managed by owners after training
Disadvantages
- Easily dislodged
- Not suitable for patients that are unconscious, vomiting, have a poor gag-reflex or have a megaesophagus
- May be vomited up
- Can only be used and left in situ for 10 days
- Small bore
- Complications: rhinitis, tracheal intubations and epistaxis
Size Used
Placement of a NO Tube
- Restrain patient
- Local anaesthetic drops can be placed in the nostrils
- NO tube measurement
- Tube insertion
- Secure the tube
Confirm the Tube Is in the Correct Place
- Use of saline
- Radiography
- Capnography
- Aspiration with a syringe
- pH assessment of fluid
Place Buster collar!!!
How Much Food to Give
- Under 2 kg and over 45 kg: RER= 70 × (BW (kg) to the ¾ power)
- Between 2 and 45 kg: RER = (30 × BW) + 70
- With RER = resting energy requirement
Feeding the Patient
- Tube must be flushed with water before and after feed (cool boiled water) to prevent blockages
- CRI (constant rate infusion) can be used with a syringe driver or pump under constant monitoring
- Medication can be administered through the feeding tube but not at the same time as the food
- Commercial food preparations are available
- Day 1: 1/3 of daily energy requirement
- Day 2: 2/3 of daily energy requirement
- Day 3 onwards: full amount
- 4–6 meals a day
- Each meal should not exceed 10 ml/kg
- Animal must be monitored for vomiting, coughing, pain, dyspnoea, abdominal distention or discharge from entry site
Owners can be taught how to use feeding tubes at home.