Access and Complications of Enteral Nutrition Support for Critically Ill Patients

2016 ◽  
pp. 63-79 ◽  
Author(s):  
Tushar D. Gohel ◽  
Donald F. Kirby
Keyword(s):  
Enteral Nutrition ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Nutrition Support ◽  
Enteral Nutrition Support

Long-term Enteral Access in Aspiration-prone Patients

1995 ◽  
Vol 10 (4) ◽  
pp. 179-186 ◽  
Author(s):  
Alex C. Cech ◽  
Jon B. Morris ◽  
James L. Mullen ◽  
Gary W. Crooks
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Enteral Nutrition ◽  
Critically Ill ◽  
Enteral Feeding ◽  
Critically Ill Patients ◽  
Nutrition Support ◽  
Enteral Access ◽  
Enteral Nutrition Support

Aspiration pneumonia is a serious complication of enteral feeding. Many critically ill patients are particularly at risk for aspiration. Few studies have rigorously compared various access devices. Risk factors for aspiration and studies examining aspiration associated with enteral feeding devices are reviewed. We recommend a surgical jejunostomy for all patients at high risk for aspiration who require more than 3 weeks of enteral nutrition support.

scholarly journals Early versus delayed enteral nutrition support for critically ill adults

2016 ◽  
Author(s):  
Paulina Fuentes Padilla ◽  
Gabriel Martínez ◽  
Robin WM Vernooij ◽  
Gerard Urrútia ◽  
Marta Roqué i Figuls ◽  
...  
Keyword(s):  
Enteral Nutrition ◽  
Critically Ill ◽  
Nutrition Support ◽  
Critically Ill Adults ◽  
Enteral Nutrition Support ◽  
Ill Adults

Parenteral nutrition in the ICU

2016 ◽  
Author(s):  
Jonathan Cohen ◽  
Shaul Lev
Keyword(s):  
Animal Models ◽  
Enteral Nutrition ◽  
Parenteral Nutrition ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Nutrition Support ◽  
Glutamine Supplementation ◽  
Artificial Nutrition ◽  
Omega 3 ◽  
Aspen Guidelines

Parenteral nutrition (PN) is a technique of artificial nutrition support, which consists of the intravenous administration of macronutrients, micronutrients, and water. PN has become integrated into intensive care unit (ICU) patient management with the aim of preventing energy deficits and preserving lean body mass. The addition of PN to enteral nutrition is known as supplemental PN. Parenteral feeding should be considered whenever enteral nutritional support is contraindicated, or when enteral nutrition alone is unable to meet energy and nutrient requirements. International guidelines differ considerably regarding the indications for PN. Thus, the ESPEN guidelines recommend initiating PN in critically-ill patients who do not meet caloric goals within 2–3 days of commencing EN, while the Canadian guidelines recommend PN only after extensive attempts to feed with EN have failed. The ASPEN guidelines advocate administering PN after 8 days of attempting EN unsuccessfully. Several studies have demonstrated that parenteral glutamine supplementation may improve outcome, and the ESPEN guidelines give a grade A recommendation to the use of glutamine in critically-ill patients who receive PN. Studies on IV omega-3 fatty acids have yielded promising results in animal models of acute respiratory distress syndrome and proved superior to solutions with omega -6 compositions. The discrepancy between animal models and clinical practice could be related to different time frames.

Interruptions in Enteral Nutrition Delivery in Critically Ill Patients and Recommendations for Clinical Practice

2014 ◽  
Vol 34 (4) ◽  
pp. 14-22 ◽  
Author(s):  
Melissa L. Stewart
Keyword(s):  
Health Care ◽  
Enteral Nutrition ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Nutrition Support ◽  
Health Care Spending ◽  
Gastrointestinal Intolerance ◽  
Technical Issues ◽  
Delivery Practices ◽  
Poor Outcomes

Malnutrition is common in critically ill patients and is associated with poor outcomes for patients and increased health care spending. Enteral nutrition is the method of choice for nutrition delivery. Enteral nutrition delivery practices vary widely, and underfeeding is widespread in critical care. Interruptions in enteral nutrition due to performance of procedures, positioning, technical issues with feeding accesses, and gastrointestinal intolerance contribute to underfeeding. Strategies such as head-of-bed positioning, use of prokinetic agents, tolerance of higher gastric residual volumes, consideration of postpyloric feeding access, and use of a nutrition support protocol may decrease time spent without nutrition.

scholarly journals Updates in Nutrition Support for Critically III Adult Patients

2017 ◽  
Vol 52 (1) ◽  
pp. 17-26 ◽  
Author(s):  
Diana Wells Mulherin ◽  
Sarah V. Cogle
Keyword(s):  
Critical Care ◽  
Enteral Nutrition ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Care Setting ◽  
Hospital Pharmacist ◽  
Critical Care Medicine ◽  
Critical Care Setting ◽  
Nutrition Support ◽  
American Society

Specialized nutrition support is often employed in critically ill patients who are unable to maintain volitional intake. The Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) recently updated guidelines for the provision of nutrition support in critically ill patients. The purpose of this review is to summarize key changes from the previous guidelines as they relate to recently published literature, which will aid the hospital pharmacist in optimizing nutrition support therapies in the critical care setting.

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