Enteral and Parenteral Nutrition

2017 ◽  
Author(s):  
Kris M. Mogensen ◽  
Malcolm K. Robinson
Keyword(s):  
Small Bowel ◽  
Parenteral Nutrition ◽  
Ethical Issues ◽  
Nutritional Assessment ◽  
Enterocutaneous Fistula ◽  
Pelvic Abscess ◽  
Nutrition Support ◽  
Tube Placement ◽  
Fistula Formation ◽  
Enteral And Parenteral Nutrition

Alternative routes of nutrient administration are available for patients who are unable to eat or digest sufficient food to prevent malnutrition. These routes include enteral (administered through the gastrointestinal tract) and parenteral (administered intravenously). This review details the clinical consequences of malnutrition, nutritional assessment, the benefits of nutrition support therapy,  determining the nutrient prescription, special considerations in nutrition support therapy, aspects of obtaining enteral or parenteral access, monitoring of patients receiving nutrition support therapy, and complications and ethical issues associated with enteral and parenteral nutrition. Figures include algorithms showing the identification of malnutrition, the nutrition support decision process, and the approach to gastric residual monitoring; nasogastric tube displacement leading to pneumothorax; proper placement of a long or “midline” catheter versus a peripherally inserted central catheter; and photographs of a 43-year-old man with Crohn disease complicated by enterocutaneous fistula formation, distal small bowel obstruction, and evisceration of the small bowel after developing a pelvic abscess. Tables list acute illness- or injury-related malnutrition; chronic disease−related malnutrition; social or environmental circumstances−related malnutrition; indications and contraindications to enteral and parenteral nutrition; selected examples of predictive equations; electrolyte provision in parenteral nutrition; parenteral vitamin and trace element requirements; complications associated with enteral and parenteral nutrition; and indications, contraindications, and complications of gastrostomy tube placement. This review contains 6 highly rendered figures, 11 tables, and 167 references.

Enteral and parenteral nutrition considerations in pediatric patients

2019 ◽  
Vol 76 (19) ◽  
pp. 1492-1510
Author(s):  
Mary Petrea Cober ◽  
Kathleen M Gura
Keyword(s):  
Best Practices ◽  
Parenteral Nutrition ◽  
Pediatric Patients ◽  
Medication Administration ◽  
Nutrition Support ◽  
Disease States ◽  
Pediatric Populations ◽  
Enteral And Parenteral Nutrition ◽  
Indications For Use ◽  
Selection Of

Abstract Purpose Current clinical practice guidelines on management of enteral nutrition (EN) and parenteral nutrition (PN) in pediatric patients are reviewed. Summary The provision of EN and PN in pediatric patients poses many unique considerations and challenges. Although indications for use of EN and PN are similar in adult and pediatric populations, recommended EN and PN practices differ for pediatric versus adult patients in areas such as selection of EN and PN formulations, timing of EN and PN initiation, advancement of nutrition support, and EN and PN goals. Additionally, provision of EN and PN to pediatric patients poses unique compounding and medication administration challenges. This article provides a review of current EN and PN best practices and special nutrition considerations for neonates, infants, and other pediatric patients. Conclusion The provision of EN and PN to pediatric patients presents many unique challenges. It is important for pharmacists to keep current with pediatric- and neonatal-specific guidelines on nutritional management of various disease states, as well as strategies to address compounding and medication administration challenges, in order to optimize EN and PN outcomes.

Our experience of enteral and parenteral nutrition support assessment in Turkey

2016 ◽  
pp. 1040-1044
Author(s):  
Deniz Erdem ◽  
Piril Tuncay ◽  
Dilek Atabey ◽  
Mutlu Doganay ◽  
Arzu sahna ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Nutrition Support ◽  
Enteral And Parenteral Nutrition

scholarly journals Survey of Clinical Nutrition Practices of Canadian Gastroenterologists

2006 ◽  
Vol 20 (8) ◽  
pp. 527-530 ◽  
Author(s):  
Harminder Singh ◽  
Donald R Duerksen
Keyword(s):  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Nutritional Assessment ◽  
Training Programs ◽  
The United States ◽  
Clinical Nutrition ◽  
Nutrition Support ◽  
Full Time ◽  
Canadian Association ◽  
Nutrition Training

OBJECTIVE: Nutrition education is a required part of gastrointestinal training programs. The involvement of gastroenterologists in clinical nutrition once their training has been completed is unknown. The aim of the present study was to determine the practice pattern of gastroenterologists in clinical nutrition and their perceived adequacy of nutrition training during their gastroenterology (GI) fellowship.METHODS: The Canadian Association of Gastroenterology mailed a survey to all of its 463 Canadian clinician members and 88 trainee members. Components of the survey included knowledge of nutritional assessment and total parenteral nutrition, involvement in a nutrition support service, physician involvement in nutritional assessment and nutrition support teams, obesity management, insertion of gastrostomy (G) tubes and management of tube-related complications, and adequacy of training in clinical nutrition.RESULTS: Sixty per cent (n=279) of the Canadian Association of Gastroenterology clinicians and 38% (n=33) of the fellows responded. Of the clinicians, 80% were practicing adult gastroenterologists with the following demographics: those practicing full time in academic centres (42%), community practice (45%), completed training in the last 10 years (32%) and those that completed training in the United States (14%). Although only 6% had a primary focus of nutrition in their GI practices, 65% were involved in nutrition support (including total parenteral nutrition), 74% placed G tubes and 68% managed at least one of the major complications of G tube insertion. Respondents felt a gastroenterologist should be the physician’s consultant on nutrition support services (89%). Areas of potential inadequate training included nutritional assessment, indications for nutrition support, management of obesity and management of G tube-related complications. The majority of clinicians (67%) and trainees (73%) felt that nutrition training in their GI fellowship was underemphasized.CONCLUSIONS: The majority of Canadian gastroenterologists are involved in nutrition support. However, this survey demonstrated that nutritional training is underemphasized in most training programs. It is important for GI fellowship programs to develop standardized nutrition training that prepares trainees for their practice.

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