ENTERAL AND PARENTERAL FEEDINGS

TUBE FEEDING

ENTERAL NUTRITION

DefinitionFeeding via tube into the gastrointestinal tract

(GIT), bypassing the oral cavity, esophagus and, if needed, the stomach.

IndicationsWhen patient cannot or will not eat enough but

GIT is still functionalExamples: oral ulcers, obstructions, dysphagia,

surgical procedures, anorexia nervosa

TF

Types: placement determines type of TF used:

NasogastricNasoduodenalGatrostomyJejunostomy

TUBE FEEDINGS – NON SURGICAL

TUBE FEEDINGS-SURGICAL

REQUIREMENTS

Nutritionally completeVarying caloric levels depending on tube

feeding – must meet individual needs Increase calorie contentincrease viscosityCHO, PRO, FAT to meet energy needsDensityVitamins and mineralsWith or without fiberLactose free

SPECIALTY FORMULAS

Stress, pulmonary, pediatric, liver, renalModular formulas

Carbohydrates

Proteins

Lipids

ADMINISTRATION

Bolus

Gravity IntermittentContinuous

COMPLICATIONS

CloggingAspirationDrug incompatibilityNausea and vomitingDiarrhea or constipationInfectionsContaminated formula

IF THE GUT WORKS, USE IT!

PARENTERAL NUTRITION

Peripheral parenteral nutritionShort – termPartially meets nutritional needs

PERIPHERAL PARENTAL NUTRITION

PARENTERAL NUTRITION

Total parenteral nutritionLong-term Nutritionally complete

TPN

INDICATIONS

Inability to use the GITHypermetabolismOthers

REQUIREMENTS

Can be tailored to meet individual needsCHO or CHO and fat for caloriesProtein (AA) to meet nitrogen needsVitamins, mineralsUnique: nutrients placed directly into

blood stream – no gut control

COMPLICATIONS

InfectionGastrointestinal atrophyRefeedingBacterial translocation