Cleaning

• No matter what intubation method is used, keeping the tubes, pump and intubation site clean is a priority. A dirty tube, pump or intubation site is a breeding ground for bacteria and therefore poses a risk for infection. Change silicone tubes that are inserted through the nose no less than once a month, and change polyvinyl chloride tubes once a week. For other intubation types, have a nurse replace the tube once a month for latex and every two to three months for silicone. Flush the tubing with water before and after each feeding to prevent formula from building up in the tube.
  
  

Delivery

• Use a controlled delivery of the formula. Controlled delivery of formula limits how much formula is delivered to the stomach at any given time or over a given time period. This method is much better at controlling blood sugar levels, aspiration from regurgitating and other tube feeding problems, such as dumping syndrome (a condition in which the contents of the stomach empty too quickly into the small intestine, causing nausea and cramps).
  
  

Formula

• Use a formula that is thinner and that doesn't have as much fiber in it. This kind of formula won't clog the tube as easily. Less fiber also prevents a delay in gastric emptying, thereby reducing the odds of regurgitation, reflux, gas and bloating.
  
  

Feeding Time

• Consider night feedings. Night feedings mean that the intubated patient may be able to disconnect herself from the feeding machine or bag during the day, providing better mobility and freedom for activities. However, if it is important to the patient to keep a daily routine of meal times to feel "normal," feed during the day.
  
  

Feeding Size

• In general, keep the amount of formula given at a feeding small. Smaller feedings generally are better because too much formula can be regurgitated and raise the risk of aspiration. Have several small feedings throughout the day instead of three large meals.
  
  

Considerations

• As an intubated person ages, his nutritional needs and medications may change. If the formula seems not to be sufficient or suddenly is problematic as this happens, it may be helpful to run some tests to see whether changes to the formula or medications need to be made.