Comparison of Gravity Flow Rates Between ENFit and Legacy Feeding Tubes

Background: Misconnections between enteral supplies and other access devices have led to significant morbidity and mortality. To reduce misconnections, a standard small-bore connector has been developed (International Organization for Standards 80369-8; ENFit). The full impact of transition to this connector is not known, however. Method: Working with major manufacturers and Food and Drug Administration, we obtained ENFit and comparative legacy tubes of variable sizes (low-profile, 14F, 18F, 20F, and 24F balloon gastrostomies). Gravity enteral feeding was simulated with an empty bolus syringe attached to the feeding tube to be tested. The tube was clamped and filled to the 60-mL mark with liquid (water, Jevity 1 Cal, Isosource HN, Isosource 1.5 Cal, Two Cal HN, and Nourish). The clamp was released, and time for formula to leave the syringe was recorded. Results: There was no difference in flow rate between the aggregate legacy and ENFit tubes for the low-profile, 18F, and 20F sizes. The ENFit 14F tubes had a lower flow rate vs the legacy tubes, largely due to the low flow rates seen with the 1 ENFit tube. Similarly, 24F ENFit tubes with some formulas yielded lower flow rates as opposed to legacy. Conclusion: Overall, for the low-profile, 18F, and 20F sizes, the ENFit tubes had similar flow rates when compared with the legacy tubes. For the 14F and 24F sizes, the flow rate of ENFit tubes was significantly lower, which could result in longer EN delivery for patients who are using these tubes to provide gravity feeding.