Enteral feeding devices safety

Some patients may have multiple tubing lines connected to them for reasons such as delivery of medication and nutrition therapy. With these multiple lines, the risk for tubing misconnections becomes more prevalent and can lead to serious adverse and even fatal events. The main reason for these iatrogenic adverse events is the ubiquitous presence of Luer-lock in direct points of access: enteral, urological, respiratory, epidural, intrathecal. The International Organization for Standardization (ISO) characterizes a connector securing project to avoid tubing misconnections. Firstly, this approach concerns enteral nutrition lines connections (ISO 80369-3, ENFit) and lines-containing (ISO 18250-3, EN+). This normative project induces the modification of enteral connectors to standardized and dedicated connectors. Connectors evolution will require a transition period, with adapters to switch to new enteral devices. As with any transition, vigilance will be needed on the risks of incompatibility between currently devices and the new standardized connectors. We illustrate the different systems used today and present regulatory changes underway that will lead to the EN+ connectivity and future connectivity standard enteral ENFit. The ISO 80369-3 standard is expected in 2015 and the new enteral devices will be available from 2016. The EN+ is not yet published but is already available into 3 enteral devices suppliers of 4. (C) 2015 Elsevier Masson SAS. All rights reserved.