enteral nutrition

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Introduction

Daily parenteral requirements:

Nutrient Quantity
essential fatty acids 1-2% of total calories
calcium 0.8-1.2 g
phosphorous 0.8.1.2 g
potassium 2-5 g
sodium 1-3 g
chloride 2-5 g
magnesium 0.3 g
iron 10 mg
zinc 15 mg
copper 2-3 mg
iodine 0.15 mg
manganese 2-5 mg
chromium 50-200 ug
molybdenum 150-300 ug
selenium 50-200 ug
ascorbate 60 mg
thiamine 1.4 mg
riboflavin 1.6 mg
niacin 18 mg
biotin 60 ug
pantothenate 5 mg
pyridoxine 2.0 mg
folate 400 ug
cobalamin 3.0 ug
vitamin A 1000 ug
vitamin D 10 ug
vitamin E 8-10 mg
vitamin K 70-140 ug

Enteral feeding tubes:

  • nasogastric tube
  • nasojejunal tube
  • gastrostomy tube
  • jejunostomy tube
  • combined gastrojejunostomy tube (G/J tube)

Indications

* if the gut works, use it

Contraindications

Complications

* when diarrhea from malabsorption leads to diminished calorie intake, diminished calorie intake is the said cause of weight loss[9]

Management

More general terms

Additional terms

References

  1. Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 477
  2. 2.0 2.1 Reignier J et al. Effect of not monitoring residual gastric volume on risk of ventilator-associated pneumonia in adults receiving mechanical ventilation and early enteral feeding: A randomized controlled trial. JAMA 2013 Jan 16; 309:249 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23321763
    Rice TW. Gastric residual volume: End of an era. JAMA 2013 Jan 16; 309:283. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23321767
  3. 3.0 3.1 3.2 3.3 3.4 3.5 3.6 Medical Knowledge Self Assessment Program (MKSAP) 16, 18, 19 American College of Physicians, Philadelphia 2012, 2018, 2022.
    Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
    Martindale RG, McClave SA, Vanek VW et al Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition: Executive Summary. Crit Care Med. 2009 May;37(5):1757-61 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19373044
  4. 4.0 4.1 Sampson EL, Candy B, Jones L. Enteral tube feeding for older people with advanced dementia. Cochrane Database Syst Rev. 2009 Apr 15;(2):CD007209. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19370678
  5. 5.0 5.1 van Zanten ARH et al. High-protein enteral nutrition enriched with immune-modulating nutrients vs standard high-protein enteral nutrition and nosocomial infections in the ICU: A randomized clinical trial. JAMA 2014 Aug 6; 312:514 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25096691
  6. 6.0 6.1 Arabi YM et al. Permissive underfeeding or standard enteral feeding in critically ill adults. N Engl J Med 2015 Jun 18; 372:2398 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25992505
  7. 7.0 7.1 TARGET Investigators, for the ANZICS Clinical Trials Group. Energy-dense versus routine enteral nutrition in the critically ill. N Engl J Med 2018 Oct 22 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30346225 Free Article https://www.nejm.org/doi/10.1056/NEJMoa1811687
  8. Taylor BE, McClave SA, Martindale RG et al Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). Crit Care Med. 2016 Feb;44(2):390-438. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26771786
  9. 9.0 9.1 Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
  10. NEJM Knowledge+ Gastroenterology