Enteral feeding in patients with major burn injury: the use of nasojejunal feeding after the failure of nasogastric feeding

Sefton, E.J.; Boulton-Jones, J. R.; Anderton, D; Teahon, K; Knights, D.T.

doi:10.1016/s0305-4179(02)00006-2

Cited by 25 publications

(15 citation statements)

References 16 publications

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“…fibrose quística, cardiopatias, doenças metabólicas) e no intena n o s Estevão-Costa J. Acessos entéricos na criança, Acta Med Port 2014 Sep-Oct;27(5):634-640 sivismo em geral. [5][6][7][8][9] …”

Section: Indicaçõesunclassified

Vias para Nutrição Artificial na Criança (I): Acessos Entéricos

Estevão‐Costa

2014

Acta Med Port

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RESUMOO aporte nutricional adequado é crucial na abordagem terapêutica de múltiplos estados mórbidos, o que justifica o recurso frequente e crescente a vias de acesso específicas para nutrição entérica e parentérica. No presente artigo é realizada uma revisão da literatura relevante acerca de indicações, modalidades, eficácia e complicações das vias de acesso entérico na criança. Os fatores a considerar na decisão entre acesso gástrico e acesso pós-pilórico, e entre colocação de sonda nasogástrica e gastrostomia são criteriosamente discutidos. Perante indicação para acesso gástrico de longa duração, a gastrostomia endoscópica percutânea é a técnica mais utilizada dada a sua eficácia e segurança, embora a morbilidade associada não seja desprezível; a colocação de gastrostomia laparoscópica emerge como uma alternativa potencialmente vantajosa. Palavras-chave: Criança; Nutrição Entérica; Intubação Gastrointestinal; Gastrostomia; Jejunostomia; Laparoscopia. ABSTRACTAppropriate nutritional support is crucial in the therapeutic approach of multiple conditions, which justifies the frequent and increasing use of specific access routes for enteral and parenteral nutrition. This article reviews the relevant literature concerning indications, procedures, effectiveness and complications of enteral access routes in children. The decision between gastric and postpyloric access, and between nasogastric tube and gastrostomy is thoroughly discussed. Percutaneous endoscopic gastrostomy is the most commonly used technique when a long-term gastric access is required, given its efficacy and safety although the associated morbidity is not negligible; laparoscopic gastrostomy emerges as a potentially advantageous alternative.

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Section: Indicaçõesunclassified

Vias para Nutrição Artificial na Criança (I): Acessos Entéricos

Estevão‐Costa

2014

Acta Med Port

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“…While some evidence shows that preoperative fasting of nasogastric feeds for <2 h may not increase aspiration risk (55), there is limited data on the safety and efficacy of this practice (56). Burn patients can develop gastric stasis (57), which increases their aspiration risk. Naso‐jejunal enteral feeds are an alternative to nasogastric feeds to minimize the risk of aspiration.…”

Section: Anesthetic Considerations For Acute Burn Proceduresmentioning

confidence: 99%

Anesthetic considerations for major burn injury in pediatric patients

Fuzaylov

Fidkowski

2009

Pediatric Anesthesia

118

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Major burn injury remains a significant cause of morbidity and mortality in pediatric patients. With advances in burn care and with the development of experienced multi-disciplinary teams at regionalized burn centers, many children are surviving severe burn injury. As members of the multi-disciplinary care team, anesthesia providers are called upon to care for these critically ill children. These children provide several anesthetic challenges, such as difficult airways, difficult vascular access, fluid and electrolyte imbalances, altered temperature regulation, sepsis, cardiovascular instability, and increased requirements of muscle relaxants and opioids. The anesthesia provider must understand the physiologic derangements that occur with severe burn injury as well as the subsequent anesthetic implications.

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“…Postpyloric feeding emerges as an alternative method for providing enteral nutrition and preventing intestinal atrophy with bacterial translocation. Sefton et al [34] reported that 59% of burn patients who could not tolerate nasogastric feeds were able to successfully tolerate nasoenteric feeds. • Despite the fact that oral feeding is known to increase abdominal pain in patients with acute pancreatitis, jejunal feeding is well tolerated, even in patients with severe pancreatitis, and is associated with a lower incidence of septic and metabolic complications as well as lower costs compared with parenteral nutrition.…”

Section: Postpyloric Enteral Nutritionmentioning

confidence: 99%

Gastric and postpyloric total enteral nutrition

Abou-Assi¹,

Khurana²,

Schubert

2005

Curr Treat Options Gastro

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The provision and maintenance of good nutrition in patients with acute and chronic illness is a fundamental part of standard medical and surgical care. Recently, there is great interest in using enteral nutritional support to reverse the morbidity and mortality associated with malnutrition. Enteral nutrition is preferred over parenteral nutrition because it is more physiologic, maintains intestinal structure and function, limits bacterial translocation, has less morbidity, has fewer complications, and is less expensive. However, the decision to feed into the stomach or into the small bowel (postpyloric) continues to be a matter of some debate and continued clinical investigation. Although the gastric route of enteral feeding is easier and less expensive, some physicians worry that gastric feeding may predispose to aspiration and pneumonia, especially in critically ill patients who frequently have delayed gastric transit. In these critically ill patients, small bowel function usually remains relatively intact and placement of a postpyloric feeding tube may permit more effective delivery of nutrients. However, it should be noted that placement of postpyloric feeding tubes can be challenging, and this may lead to a delay in initiation of nutritional support.

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Enteral feeding in patients with major burn injury: the use of nasojejunal feeding after the failure of nasogastric feeding

Cited by 25 publications

References 16 publications

Vias para Nutrição Artificial na Criança (I): Acessos Entéricos

Vias para Nutrição Artificial na Criança (I): Acessos Entéricos

Anesthetic considerations for major burn injury in pediatric patients

Gastric and postpyloric total enteral nutrition

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