ENTERAL FEEDING

MIC-KEY* LOW-PROFILE BALLOON GASTROSTOMY FEEDING TUBES (MIC-KEY* G) WITH ENFit^® EXTENSION SETS

Fit for All Stages – From Paediatric, Teens, Through To Adult

The need for enteral feeding can be medically, emotionally and psychologically complex and impact lifestyle choices. Traditional feeding tubes may be too obvious and difficult to conceal and also be at risk of getting caught or accidentally pulled out – all of which add stress to a possibly already complicated life. Good nutrition maintains health, promotes growth and supports healing. MIC-KEY* G Feeding Tubes are indicated for use in paediatric and adult patients who require long term feeding, are unable to tolerate oral feeding, who are at low risk for aspiration, require gastric decompression and/or medication delivery directly into the stomach. MIC-KEY* G Feeding Tubes provide greater discretion, freedom and mobility via a skin-level feeding tube to keep your patients nourished and
supported.

Product Features:

• Medical Grade Silicone Construction
• Low-Profile Design
• Tapered Distal Tip
• Silicone Internal Retention Balloon
• Distal Tip Recessed at 5ml
• Proximal Anti-Reflux Valve
• SECUR-LOK* ENFit^® Extension Set Connector Mechanism
• Radiopaque Stripe
• Wide Variety of ENFit^® Extension Sets Available

MIC-KEY* LOW-PROFILE BALLOON GASTRIC-JEJUNAL FEEDING TUBES (MIC-KEY* GJ) WITH ENFit^® EXTENSION SETS
ENDOSCOPIC/RADIOLOGIC PLACEMENT

The MIC-KEY* GJ Tube is designed for patients who require simultaneous gastric decompression/drainage and delivery of enteral nutrition into the distal duodenum or proximal jejunum. A low-profile version of the MIC* Gastric-Jejunal Feeding Tube, the MIC-KEY* GJ Tube is accessed using MIC-KEY* Extension Sets with ENFit^® Connectors. The MIC-KEY* GJ Tube is unobtrusive and easy to conceal. There are a wide range of sizes and lengths available. The added benefit of the tungsten weighted jejunal portion helps to maintain tube position, resist kinking and increase radiopacity.

Features:

• Clearly marked separate ENFit^® Gastric and Jejunal ports for ease of identification and simultaneous jejunal feeding and gastric decompression
• Multiple feeding exit ports to help improve flow and minimise clogging
• In-line jejunal port to aid in over-the-wire placement
• Tapered distal tip for non-traumatic tube insertion

MIC-KEY* LOW-PROFILE BALLOON JEJUNAL FEEDING TUBES (MIC-KEY* J) WITH ENFit^® EXTENSION SETS

Low-Profile Jejunal Feeding

The MIC-KEY* J Tube is designed for patients who require delivery of enteral nutrition into the distal duodenum or proximal jejunum. A low-profile version of the MIC* Jejunal Feeding Tube, the MIC-KEY* J Tube is accessed using MIC-KEY* Extension Sets with ENFit^® Connectors. Offering a wide range of sizes and lengths for adult and paediatric patients the MIC-KEY* J Tube is unobtrusive and easy to conceal.

MIC* BALLOON GASTROSTOMY FEEDING TUBES (MIC* G) WITH ENFit^® CONNECTORS

The MIC* G Feeding Tube is indicated for patients requiring continuous enteral feeding while allowing separate access for medication and water flushes. 2 Gastric ports with ENFit^® connectors access the stomach for the delivery of enteral feeds, water flushes and medication into the stomach.

Product Features:

• Medical grade silicone construction
• White balloon port labeled ‘BAL’ to indicate it is only to be used to inflate and deflate the retention balloon in the stomach
• Fr size and recommended balloon volume are labeled on the white balloon port
• Cm markings along the length of the tube
• SECUR-LOK* external retention disc
• Radiopaque stripe along the length of the tube
• Inflatable silicone internal retention balloon
• Recessed distal tube tip at the recommended fill volume

MIC* BALLOON BOLUS GASTROSTOMY FEEDING TUBES (MIC* G BOLUS) WITH ENFit^® CONNECTORS

The MIC* Bolus Gastrostomy Feeding Tube is utilised for patients who are on a bolus feeding regime. The MIC* G Bolus feeding tube has the same product features as the MIC* G feeding tube with the exception of a single ENFit^® gastric port where the MIC* G has 2 ENFit^® gastric ports. The single ENFit^® connector, labelled ‘Gastric’, is for delivery of bolus enteral feeds, water flushes and medication into the stomach.

MIC* BALLOON GASTRIC-JEJUNAL FEEDING TUBES (MIC* GJ) WITH ENFit^® CONNECTORS

Surgical, Radiologic or Endoscopic Placement

The MIC* Gastric-Jejunal (GJ) Feeding Tube with ENFit^® connectors is designed for patients who require simultaneous gastric decompression/drainage and delivery of enteral nutrition into the distal duodenum or proximal jejunum. It is indicated for use in patients who cannot absorb adequate nutrition through the stomach, who have intestinal motility problems, gastric outlet obstruction, severe gastroesophageal reflux, are at risk of aspiration, or in those who have had previous esophagectomy or gastrectomy. The MIC GJ Feeding Tube comes in a variety of sizes and lengths to help ensure an accurate fit – 16, 18 and 22 Fr outer diameter with multiple lengths. It has a weighted jejeunal section. It can be used as initial placement or replacement into an existing stoma tract.

MIC* BALLOON JEJUNAL FEEDING TUBES (MIC* J) WITH ENFit^® CONNECTORS

The MIC* Jejunal (J) Feeding Tube with ENFit^® connector allows for delivery of enteral nutrition and medication via an access port labeled ‘Jejunal’ into the distal duodenum or proximal jejunum. The MIC* J Tube is intended for placement through a gastric stoma, and has an internal retention balloon and is a suitable option for patients who:

• Cannot absorb adequate nutrition through their stomach
• May have intestinal motility problems
• May have gastric outlet obstruction
• Suffer from severe gastro-oesophageal reflux
• Are at risk of aspiration
• Have had UGI surgery e.g. oesophagectomy or partial gastrectomy

Available in different sizes to meet individual adult and paediatric patient needs, these tubes can be placed:

• Endoscopically under endoscopic guidance
• Radiologically under fluoroscopic guidance
• Surgically or as replacement to an existing feeding tube using an established stoma tract.

Product Features:

• Medical grade silicone construction
• Single access port with ENFit^® connector labeled ‘Jejunal’
• White port labeled BAL – to inflate and deflate the internal retention balloon
• J Tube stoma Fr size is printed on the BAL port
• Cm markings
• SECUR-LOK* external retention ring
• Radiopaque stripe along length of the tube
• Distal end can be trimmed for specific patient requirements

MIC* JEJUNOSTOMY FEEDING TUBE

The MIC* Jejunostomy tube can be used in patients affected by head and neck, upper gastrointestinal or gastric carcinomas or degenerative musculoskeletal or neuromuscular conditions. Intended for placement during a surgical procedure, the MIC* Jejunostomy Feeding Tube can ensure long-term feeding and nutrition goals are achieved.

Product Features:

• Medical grade silicone construction
• 14Fr Outer Diameter and 9Fr Inner Diameter
• Proximal and distal wings hold the tube in place via a Witzel tunnel
• Dacron cuff lies in the subcutaneous space
• No external fixation required
• Discreet profile

CORFLO* MAX PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG) KITS WITH ENFit^® CONNECTORS

PULL Placement Method

Product Features:

• ENFit^® compliant adaptor for formula, medication and water delivery
• Unique polyurethane foam internal bumper which collapses during insertion and traction removal
• Polyurethane tube
• Radiopaque stripe
• Tubing clamp
• External retention options – Straight or 90 degree
• Sizes 12Fr, 16Fr and 20Fr with Ring internal fixation
• Size 20Fr with Conical internal fixation

MIC* PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG) KITS & REPLACEMENT ADAPTERS WITH ENFit^® CONNECTORS

Push & Pull Methods

The MIC* PEG Feeding Tube Kit is designed for placement convenience and comes in complete placement kits for both the PULL and PUSH (Over-The-Wire, OTW) placement methods.

Product Features:

• Medical grade silicone construction
• ENFit^® compliant access ports for formula, medication and water delivery
• SECUR-LOK* external retention ring
• Cm markings along length of tube
• Traction removable with collapsible internal retention bumper
• External bolster is ventilated to allow air circulation around stoma
• Sizes 14Fr, 20Fr, 24Fr for adult and paediatric placement
• Tubing clamp

CORFLO* PEG JEJUNAL TUBE WITH ENFit^® CONNECTORS

Jejunal Extension Tubes designed specifically for use with CORFLO* MAX PEG tubes (PEJ).

Placement options:
a) “Beside the scope” using the weighted Grip-Tip
b) Over-The-Wire (OTW) using Teflon-coated flexible 260cm wire through a non-weighted open end

Product Features:

• ENFit^® compliant
• Distinctive YELLOW tube design
• Polyurethane tube
• Length, French size and cm markings printed on tube
• Dual port allows simultaneous feeding, flushing and/or delivery of medications without unnecessary disconnection from feeding lines
• Anti-clog exit port
• Water activated C-19™ hydrophilic lubricant on tip and internal lumen
• Radiopaque tube
• Tungsten weighted (1gm or 3gm) or non-weighted
• MRI Conditional (with stylet removed, MRI: ≤ 3 Tesla)
• Adjust a sleeve for length adjustment and connection to CORFLO* MAX PEG Adapter
• Double lumen connector allowing for gastric decompression and jejunal feeding
• Range in sizes 6Fr – 10Fr

MIC-KEY* INTRODUCER KIT FOR GASTROSTOMY, JEJUNAL & GASTRIC-JEJUNAL FEEDING TUBES

To facilitate the primary placement of balloon retained MIC* and MIC-KEY* Gastrostomy, Jejunal and Gastric-Jejunal Feeding Tubes during Endoscopic, Radiologic or Laparoscopic placement procedures.

Product Features:

• One convenient kit
• Tools specifically designed for visual and surgical accuracy
• Sharp safety designed gastrointestinal anchor set, scalpel and introducer needle
• Flexibility as adjunctive or primary procedure (MIC* G, J or GJ or MIC-KEY* G, J or GJ Feeding Tubes)
• For tube sizes 12Fr – 20Fr

INTRODUCER KIT COMPONENTS – GASTROINTESTINAL ANCHOR SET SAF-T-PEXY* T-FASTENERS

Intended to affix the stomach to the anterior abdominal wall facilitating primary placement of the Avanos branded MIC* and MIC-KEY* enteral feeding tubes.

EFFICIENT CLINICAL SOLUTION

• Simple, Intuitive Anchoring Sutures
  • Confidently secure the stomach
  • Audible confirmation of suture lock
  • Suture lock can be bi-directionally adjusted during application
• Promotes Patient Compliance & Comfort
  • Absorbable sutures
  • Promotes patient hygiene with easy-to-clean bolsters
  • Smooth, round retention device for patient comfort
•  Controlled Delivery
  • One-hand, on-demand T-bar deployment
  • Pre-loaded needles – Protects clinician from inadvertent needle stick injury

INTRODUCER KIT COMPONENTS – ENTERAL ACCESS DILATION SYSTEM

Proprietary Serial Dilator with Peel-Away Sheath

Product Features:

• Allows Seldinger Technique so reduced need for repeat passing of dilators over a guide wire
• Achieve desired dilation with a single telescopic device
• Integrated Peel-Away Sheath facilitates feeding tube placement
• Made for MIC* and MIC-KEY* feeding tubes from sizes 12Fr – 20Fr

CLOG ZAPPER* ENTERAL FEEDING TUBE DECLOGGING SYSTEM

In clinical usage CLOG ZAPPER* was successful in restoring patency to feeding tubes clogged with enteral formulas over 75% of the time ^1,2

CLOG ZAPPER* is food graded and combines an “enzyme cocktail,” acids, buffers, anti-agents, and metal inhibitors. The ingredients all work together to loosen, break down and dislodge clogs. The enzymatic formula reduces clogging more effectively than water flushing alone.

EXTENSION SETS

A Comprehensive Selection

Avanos offers a variety of ENFit^® extension sets for continuous feeding, bolus feeding and medication delivery for:

• MIC-KEY* Feeding Tube Kits
• MIC* Feeding Tube Kits
• CORFLO* Feeding Tube Kits

CORFLO* NASOGASTRIC / NASOINTESTINAL FEEDING TUBES WITH ENFit^® CONNECTORS

The Avanos CORFLO* NG/NI feeding tubes are available in a wide variety of adult, paediatric and neonatal sizes. Their polyurethane construction makes them excellent for long-term intubation and offers a larger lumen than PVC tubes and Silicone tubes of the same French size.

Features:

• ENFit^® compliant
• Distinctive YELLOW tube design
• Polyurethane tube
• Length, French size and cm markings printed on tube
• Dual port allows simultaneous feeding, flushing and/or delivery of medications without unnecessary disconnection from feeding lines
• Anti-clog exit port
• Water activated C-19™ hydrophilic lubricant on tip and internal lumen
• Radiopaque tube and tip
• Tungsten weighted (1gm, 3gm or 7gm) or non-weighted
• Braided stainless steel stylet or non-stylet options
• Range in sizes 6Fr – 12Fr
• No indicated in-dwell time. Tube should be monitored, regularly assessed and replaced when clinically indicated based on functionality and patient condition

CORFLO* NASOINTESTINAL ENDOSCOPICALLY PLACED FEEDING TUBE WITH ENFit^® CONNECTORS

CAN BE PLACED BY EITHER ENDOSCOPIC OR FLUOROSCOPIC PROCEDURES.

This ENFit^® polyurethane nasoenteric feeding tube has been specifically designed for the placement in the small bowel over a guidewire under endoscopic and fluoroscopic procedures. Features include:

• ENFit^® compliant
• Distinctive YELLOW tube design
• Length, French size and cm markings printed on tube
• Dual port allows simultaneous feeding, flushing and/or delivery of medications without unnecessary disconnection from feeding lines
• Anti-clog exit port
• Open end tip
• Water activated C-19™ hydrophilic lubricant on both the bolus and internal lumen of tubes
• Radiopaque along length of tube
• Teflon* coated flexible guidewire (0.035″) in dispenser sheath
• Nasal/oral transfer tube, 56cm
• 2 sizes
  • 10Fr, non-weighted
  • 12Fr, tungsten weighted, approximately 7gm

CORGRIP* NG/NI FEEDING TUBE RETENTION SYSTEM

Inadvertent dislodgement of feeding tubes has been reported with a prevalence of up to 63% ³. Feeding tube securement techniques have been used in clinical practice for more than two decades and the use of feeding tube retention systems can:

• Result in a decrease in unnecessary X-rays for replacement procedures
• Prevent discomfort and potential trauma from repeated procedures

CORGRIP* Nasogastric/Nasointestinal Tube Retention System can:

• Lower the risk of patients undergoing replacement procedures
• Reduce facility costs as a result of improved patient outcomes related to continuous enteral therapy and fewer procedures

The CORGRIP* has been designed to prevent inadvertent removal or displacement of feeding tubes in adult patients, CORGRIP* Nasogastric/Nasointestinal Tube Retention System is indicated for use with enteral feeding tubes of 8 Fr and greater and NG decompression, suction and drainage tubes up to 18 Fr.

Use of the CORGRIP* system can increase a patient’s caloric intake and may help to avoid unnecessary escalation to percutaneous endoscopic gastrostomy feeding or intravenous nutrition.

The CORGRIP* System components include:

• Water-soluble Lubricant
• White Retrieval Catheter
• Yellow Retrieval Catheter
• Opening Device
• SSL* (Slot-Slide-Lock) Camp

References:
1. Frankel EH, Enow NB, Jackson KC, Kloiber LL. Methods of restoring patency to occluded feeding tubes. Nutr Clin Pract. 1998;13(3):129-131
2. Lord LM. Restoring and Maintaining Patency of Enteral Feeding Tubes. Nutr Clin Pract. 2003;18(5):422-4263.
3. Scott R, Bowling TE, J R Coll Physicians Edinb 2015;45:49-54