PP432 - TUBE FEEDING INTOLERANCE IN HEAD AND NECK CANCER: A CROSS-SECTIONAL SURVEY OF NORDIC HEALTHCARE PROFESSIONALS
PP432
TUBE FEEDING INTOLERANCE IN HEAD AND NECK CANCER: A CROSS-SECTIONAL SURVEY OF NORDIC HEALTHCARE PROFESSIONALS
R. Lindström1, E. C. Kjellberg2, L. D. Brøchner3, I. Wessel4, A. Rytter4,*
1Sektion Klinisk Nutrition Vuxen, Karolinska Universitetssjukhuset, Huddinge, 2ÖNH-kliniken, Sahlgrenska Universitetssjukhus, Göteborg, Sweden, 3Afdeling for Medicinske Mave- og Tarmsygdomme, Aalborg Universitetshospital, Aalborg, 4Clinical Nutrition Center, Department of Transplantation and Digestive Dieseases, Rigshospitalet, Copenhagen, Denmark
Rationale: Early enteral nutrition is a core element of Enhanced Recovery After Surgery (ERAS) in head and neck cancer (HNC) and recommended within 24 hours postoperatively. Patients with HNC are at high risk of malnutrition due to tumor location and treatment effects, making tube feeding common. However, the definition, prevalence and management of enteral feeding intolerance (EFI) remain unclear and variable in clinical practice. This study aims to explore HCP experiences and opinions regarding post-op EN intolerance in patients with oral cavity and/or pharyngeal cancer and identify areas needing standardisation.
Methods: A cross-sectional survey was conducted in March 2025 among nurses, dietitians, and physicians from otorhinolaryngology centers in Denmark, Norway and Sweden. Data were collected via REDCap and analyzed descriptively; open-ended responses underwent thematic clustering.
Results: Twelve centers (Denmark n=4, Norway n=2, Sweden n=6) participated, representing 80% of regional HNC centers. Eighteen of 39 professionals responded; 50% were dietitians. Nutritional guidelines existed in 86% of centers, with 61% addressing tube feeding issues. EFI was reported as occurring “sometimes” by 73% of respondents, “never” by 13%, and “always” by none. In 60% of cases, surgeons decided preoperative nasogastric tube placement; 33% reported routine perioperative placement. Common reasons for not initiating tube feeding included oral intake, patient acceptance, and nutritional impact symptoms (NIS). Discontinuation was mainly due to NIS, oral intake, and poor tube acceptance.
Conclusion: EFI is multifactorial, involving organisational, patient centered and physiological factors. These findings highlight the need for a universal definition and standardised management to better estimate prevalance, compare interventions and improve outcomes.
Disclosure of Interest: None declared