Gentle Care in IV Nutrition Therapy: Why It’s Essential

| Last updated on November 3, 2023

Every day, tens of thousands of Americans courageously navigate life tethered to intravenous nutrition therapy (IVNT), a critical lifeline to their health and vitality. 

These patients, grappling with certain health conditions, depend on this prescribed medical treatment to receive their vital nutrition. Most often, nutrient-rich infusions are delivered through specialized IV catheters placed in their chest or arm.

However, this vital lifeline is not without its share of challenges and risks. The simple act of inserting a medical device into the body introduces a risk of infection, which can turn a lifesaving intervention to a complex health challenge. Moreover, the daily reality of living with a line or tube inserted into your body can often be a source of discomfort, distress, and constant distraction.

Yet, these patients deserve more than just life-sustaining care; they have the right to live free from the irritation, pain, and anxiety of potential infection associated with their IV lines.

Not only do patients require the strongest protection against infection, but a shield that doesn't compound their struggle with harsh side effects often associated with painful medical adhesives. The path towards better health should be paved with gentler protective measures that prioritize patient comfort alongside safety.

In this article learn more about:

  • The purpose of IV nutrition therapy 
  • Protecting IV nutrition catheters and NG tubes from infection 
  • Using gentler medical dressings to keep IV lines and NG tubes safe

Key takeaways:

  • Approximately 30,000 - 35,000 Americans live with an IV line to get the nutrients and calories they need on a daily basis
  • Approximately 1.2 million temporary NG tubes are inserted annually
  • Infection and catheter-associated complications are two of the top preventable complications patients needing IV nutrition therapy face
  • Living with lines and tubes can be made more comfortable through the use of medical dressings and devices designed with compassion

The purpose of IV nutrition therapy

For most people, nutrition, hydration and calorie intake comes from the consumption of food and water. 

However, some people are unable to swallow or absorb enough nutrition to sustain their physical needs.

Some medical conditions, such as various types of cancer (eg. throat, stomach, oesophagus, etc), or other gastrointestinal illnesses make consuming and processing food through the usual means very difficult. 

Also, cancer treatments like chemotherapy often cause nausea and vomiting in recovering patients, and radiation therapy to the brain, gastrointestinal tract, or liver can have the same effect. 

Tube feeding and IV nutrition therapy helps people who are unable to consume or absorb nutrients normally. For patients who are dealing with a variety of health challenges - from surgery recovery to severe illness and malnutrition - these therapies can be the difference between deteriorating health and the journey towards recovery. 

Some patients require IV nutrition therapy or total parenteral nutrition (TPN) for life. It’s important to note that IV nutrition therapy and TPN are different. 

Understanding TPN and IVNT: Similarities and Differences

While both TPN and IVNT involve intravenous nutrient delivery, their objectives and components differ.

TPN is a holistic nutritional approach, providing macronutrients, electrolytes, and a myriad of essential nutrients as a full dietary replacement. Conversely, IVNT primarily delivers specific nutrients without the protein, fat, and carbohydrates present in TPN.

TPN serves as a surrogate source of nourishment when a person's capacity to eat or absorb nutrients is compromised, often due to surgery or incapacitation. On the other hand, IVNT aims to enhance healing and replenish insufficient vitamin and mineral levels in the body, as opposed to replacing entire meals like TPN

Nutrition support therapy, can be administered via: 

  • Enteral nutrition – sustenance provided through a feeding tube, either nasogastric (NG) tube inserted through the nose, or gastrostomy tube (g-tube) inserted through the stomach into a different part of the GI tract.
  • Parenteral nutrition – wherein nutrients and hydration are provided directly into the bloodstream near or into the heart. 

IV nutrition therapy

IV nutrition therapy is the insertion of an IV catheter into a vein to deposit the right amount of nutrients, minerals, fluids and calories directly into a patient’s bloodstream. 

Patients may require a temporary or permanent IV line for their nutrition intake. The nutrients administered may be partial supplementation of nutrients, or a complete provision of all necessary nutrients, also known as total parenteral nutrition. 

IV therapy can be administered through two different vein systems: 

  • A central vein
    • The central vein is larger and therefore allows a larger catheter to be inserted into the bloodstream, carrying higher concentrations of nutrition containing more calories. Central veins transport medicines or fluids directly to the heart.
  • A peripheral vein  
    • Peripheral veins are smaller and are used for partial, temporary parenteral therapy in veins that allow medicines and fluids to more quickly make their way through the bloodstream. 

Approximately 30,000 - 35,000 people in America rely on an IV to get the nutrients and calories they need to remain healthy while managing certain medical conditions. 

Nasogastric and gastrostomy tubes

Nasogastric tubes are inserted through the nose to provide nutrients or medication directly into a patient’s intestines. 

NG tubes are used: 

  • If there is an illness causing the digestive process to be ineffective
  • If there is a blockage along the GI tract 
  • If the patient has severe mouth, throat or stomach pain
  • If the patient has an illness or is receiving treatment that causes excessive vomiting
  • If the patient is a young infant, such as a premie in the NICU, and can’t get enough calories by mouth

Gastrostomy tubes (G-tubes) are fed into bodies to various points along the gastrointestinal tract, depending on the location in a patient’s body where an illness is manifesting, or how well they are able to receive nutrients directly into the stomach. 

The primary causes of an NG tube placement are: 

  • Stroke
  • Cancer 
  • Head injury
  • Dementia 
  • Prematurity 

NG and G-tubes in the most vulnerable patients 

NG tubes and G-tubes are often used for infants and children who have: 

  • Congenital problems of the mouth, oesophagus, stomach or GI tract 
  • Premature birth
  • Failure to thrive (ie. a failure to gain weight quickly enough to remain healthy)
  • Sucking or swallowing disorders
  • Extreme reactions to taking necessary medications 

Children are born to move, explore and touch their world around them, even the tiniest of babies are ready to wiggle and grasp. Medical dressings are needed to secure devices like NG tubes to their body, however their delicate skin along with their desire to move, makes young patients susceptible to the adverse events such as tube dislodgement, skin tears, medical adhesive-related irritation and discomfort. 

Consider a fragile premature infant, with an NG tube affixed to their tiny face. The repeated removal and reapplication of these tubes and their accompanying dressings on such tender skin can lead to unwanted, painful skin reactions. 

No parent should bear the distress of witnessing their child endure additional discomfort, beyond their existing medical complications. Fortunately, these dressing-related complications can be avoided, thanks to innovations in medical dressing designed for gentle care, like CovaClear IV. 

Protecting IV nutrition catheters and NG tubes from infection 

As direct lines into the body, IV nutrition catheters and NG tubes must be protected from harmful bacteria that could result in infections such as: 

Furthermore, the skin around an IV line or feeding tube needs special care to protect against medical adhesive skin injury (MARSI) and external pathogens that could lead to infection.

While the insertion and removal of lines and tubes requires strict infection prevention practices be adhered to, there are critical tips patients living with lines and tubes, and their caregivers, need to keep in mind:

  • Keep the skin clean and dry 
  • For IV lines:
    • Monitor the insertion sites for redness, swelling, irritation or pain 
    • Speak to a medical professional if there is a hard lump in the vein at the insertion site, or if you see fluid coming back through the catheter from the vein
  • For patients with feeding tubes:
    • Speak to a medical professional immediately if there is fluid coming back up through the tube, or if the patient experiences choking or aspiration with an NG feeding tube inserted. 
  • Protect skin integrity around insertion sites with gentle medical dressings to avoid painful removal during dressing changes

 

Food for thought: healing shouldn’t hurt 

While many medical dressings used in healthcare provide robust infection prevention through strong acrylic adhesives and antibacterial agents like chlorhexidine, they can also result in unwelcome side effects such as skin irritation, tearing, and allergic reactions.

Yet, effective infection prevention need not compromise the compassionate care patients deserve. 

Thanks to innovative advancements, we now have access to medical dressings constructed with soft silicone securement and antibacterial agents silver or chlorhexidine integrated within the dressing itself. This combination offers not only robust protection against infections but also a gentler, more compassionate approach to patient care.

Experience the difference apology-free IV dressings can make by requesting a sample of CovaClear IV today! 

From hospital to home: keeping IV lines and NG tubes safe, secure and comfortable

From tiny babies to elderly loved ones, many people live at home receiving nutrition therapy through IV catheter or g-tube support. 

Every person living with frequent or continuous support from IV lines and NG tubes deserves to feel as comfortable, safe and secure as possible, with the greatest degree of freedom from the risks and irritation that can come with the insertion of a line or tube. 

Below are two resources patients and caregivers can consider to find empowerment, support and compassionate care: 

The Oley Foundation

The Oley Foundation is a home nutrition therapy community and advocacy group whose mission is to enrich the lives of those living at home with IV nutrition or feeding tubes. The Oley Foundation is a place in which patients are united, supported and empowered to thrive on home nutrition support. 

Covalon’s Compassionate Medical Dressings

Covalon uses compassion-driven innovation to create world-class medical dressings designed to provide patients with the highest level of comfort and protection against infections. 

CovaClear IV, known as the “skin saving dressing” is a soft silicone solution designed to save the skin from reactions, burns, tears and trauma. CovaClear IV can be used to protect peripheral IV catheters, central lines, and other percutaneous devices, like NG and g-tubes for feeding. 

Reach out and request free samples to experience the Covalon difference today! 

Resources

Cleveland Clinic: Living on Liquids

National Library of Medicine: Placement of Nasogastric Tubes 

Cleveland Clinic: Digestive System

National Library of Medicine: The digestive System and How it Works 

National Cancer Institute: Nausea and vomiting related to treatment 

Oley Foundation

Cleveland Clinic: Parenteral nutrition 

National Library of Medicine: Nasogastric tube 

Cincinnati Children’s Hospital: Health library - gastronomy tube care 

Canadian CAncer Society: Tube feeding and intravenous nutrition 

National Library of Medicine: Nationwide prevalence and outcome of NG tube placement 

Kids Health: Gastrostomy tube 

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