Highlighter is on. Drag to highlight text. Click a highlight to remove it.
ALL / Gastroenterology

Enteral feeding

Enteral feeding

Key points
  • Identify patients as malnourished or at risk (see below)
  • Identify unsafe or inadequate oral intake with functional GI tract
  • Consider for enteral feeding
  • Gastric feeding unless upper GI dysfunction (then for duodenal or jejunal tube)
  • Check NG placement using aspiration and pH (check post pyloric tubes with AXR)
  • Gastric feeding > 4 weeks consider long-term gastrostomy
  • Consider bolus or continuous feeding into the stomach
  • ITU patients should have continuous feeding for 16-24h (24h if on insulin)
  • Consider motility agent in ITU or acute patients for delayed gastric emptying. If this doesn't work then try post pyloric feeding or parenteral feeding.
  • PEG can be used 4 hours after insertion, but should not be removed until >2 weeks after insertion.

Surgical patients due to have major abdominal surgery: if malnourished, unsafe swallow/inadequate oral intake and functional GI tract then consider preoperative enteral feeding.

Patients identified as being malnourished
  • BMI < 18.5 kg/m2
  • unintentional weight loss of > 10% over 3-6/12
  • BMI < 20 kg/m2 and unintentional weight loss of > 5% over 3-6/12

AT RISK of malnutrition
  • Eaten nothing or little > 5 days, who are likely to eat little for a further 5 days
  • Poor absorptive capacity
  • High nutrient losses
  • High metabolism

Complications

Recognised complications of enteral feeding include:
  • diarrhoea
    • occurs in around 1 in 6 patients
    • the mechanism is unknown
  • aspiration
  • metabolic
    • hyperglycaemia
    • refeeding syndrome
+PassMedicine Notes
Key points
  • Identify patients as malnourished or at risk (see below)
  • Identify unsafe or inadequate oral intake with functional GI tract
  • Consider for enteral feeding
  • Gastric feeding unless upper GI dysfunction (then for duodenal or jejunal tube)
  • Check NG placement using aspiration and pH (check post pyloric tubes with AXR)
  • Gastric feeding > 4 weeks consider long-term gastrostomy
  • Consider bolus or continuous feeding into the stomach
  • ITU patients should have continuous feeding for 16-24h (24h if on insulin)
  • Consider motility agent in ITU or acute patients for delayed gastric emptying. If this doesn't work then try post pyloric feeding or parenteral feeding.
  • PEG can be used 4 hours after insertion, but should not be removed until >2 weeks after insertion.

Surgical patients due to have major abdominal surgery: if malnourished, unsafe swallow/inadequate oral intake and functional GI tract then consider preoperative enteral feeding.

Patients identified as being malnourished
  • BMI < 18.5 kg/m2
  • unintentional weight loss of > 10% over 3-6/12
  • BMI < 20 kg/m2 and unintentional weight loss of > 5% over 3-6/12
AT RISK of malnutrition
  • Eaten nothing or little > 5 days, who are likely to eat little for a further 5 days
  • Poor absorptive capacity
  • High nutrient losses
  • High metabolism

Complications

Recognised complications of enteral feeding include:
  • diarrhoea
    • occurs in around 1 in 6 patients
    • the mechanism is unknown
  • aspiration
  • metabolic
    • hyperglycaemia
    • refeeding syndrome


Saved ✓

MEDIA