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Radiographic Score of McClave et al for Evaluating a Patient with an Enteral Feeding Tube

Purpose: To monitor abdominal X-rays before and after an enteral feeding using the scoring system of McClave et al.

Description

McClave et al developed a score for monitoring radiographic changes in a patient with an enteral tube. These can help monitor a patient with an enteral tube for signs of intolerance. The authors are from the University of Louisville, the Veterans Affairs Medical Center in Louisville, and Diabetes Research in Lexington, Kentucky.


The patient is evaluated while (1) fasting and (2) after a feeding.

 

Parameters for the fasting and feeding radiographs:

(1) distended gastric bubble

(2) distended loops of bowel

(3) air-fluid levels

 

Parameter

Finding

Points

distended gastric bubble

none

0

 

mild

1

 

moderate

2

 

marked

3

distended loops of bowel

none

0

 

1 or 2 loops (mild)

1

 

3 or 4 loops (moderate)

2

 

>= 5 loops (marked)

3

air-fluid levels

none

0

 

1 or 2 loops (mild)

1

 

3 or 4 loops (moderate)

2

 

>= 5 loops (marked)

3

 

fasting X-ray score =

= SUM(all 3 parameters while fasting)

 

post-feeding X-ray score =

= SUM(all 3 parameters after a feeding)

 

total score =

= (points for fasting X-ray) + (points for post-feeding X-ray)

 

Interpretation:

• minimum score: 0

• maximum score for fasting or feeding: 9

• maximum total score (fasting + feeding): 18

• The higher the score the more likely that there may be a problem with continuing enteral feedings.


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Specialty

Objective

ICD-10