D. Types of Tubes (6,7)

1. Feeding tubes

a. Single-lumen tubes are used for gastric or transpyloric feeding via the oral or nasal route, or for temporary gastric decompression of air or gastric contents.

They are made of silastic, silicone, polyurethane, or

polyvinyl chloride (PVC) and are radio-opaque for

location on radiography. They are incrementally

marked in centimeters, and usually have two to four

side holes at the distal end (Fig. 40.1A).

(1) Silastic, silicone, and polyurethane tubes are

softer and can remain in situ for up to 30 days, or

per manufacturer’s recommendations, although

individual practice guidelines should be followed. Silastic tubes are preferred, especially in

preterm infants weighing <750 g (8).

(2) PVC tubes are stiffer and easier to insert.

However, they are not recommended for longterm use because the plasticizers are leached,

stiffening the tube and can lead to esophageal

perforation (8,9). Manufacturer recommendations for frequency of tube change can range

from every 6 hours to every 5 days, so individual

practice guidelines should be followed.

b. Available for neonates in sizes 3.5 to 8 Fr and in a

variety of lengths. The smaller diameter tubes will

have slower rates of flow. Tube length will vary

depending on the depth of placement and whether

the tube is to be gastric or transpyloric.

c. Weighted, stylet-containing tubes are not recommended in the neonatal population due to the risk

of perforation.

2. Suction/decompression tubes

a. Single-lumen feeding tubes maybe used for occasional or intermittent nasogastric aspiration of stomach contents.

b. Double-lumen (Replogle) tubes are preferable for

continuous gastric decompression or for continuous

suction to clear secretions from the upper esophageal pouch in infants with esophageal atresia prior

to surgery (10–12).

(1) The wider lumen is attached to the suction

device for gastric decompression or esophageal

clearing, and the second, smaller lumen is for

airflow to prevent adherence of the catheter to

the mucosal wall (Fig. 40.1B).

(2) These catheters are also radio-opaque, marked

incrementally and have multiple side holes at

the distal end.

(3) Available in 6, 8, and 10 Fr; vary in length.

Manufacturer’s recommendations should be followed for frequency of tube change.