Ernährungssonden bei kritisch kranken Patienten

Abstract

The use of enteral feeding tubes is an important part of early enteral feeding in intensive care medicine. In other faculties with non-critically ill patients, such as (oncologic) surgery, neurology, paediatrics or even in palliative care medicine feeding tubes are used under various circumstances as a temporary or definite solution. The advantage of enteral feeding tubes is the almost physiologic administration of nutrition, liquids and medication. Enteral nutrition is thought to be associated with a reduced infection rate, increased mucosal function, improved immunologic function, reduced length of hospital stay and reduced costs. However, the insertion and use of feeding tubes is potentially dangerous and may be associated with life-threatening complications (bleeding, perforation, peritonitis, etc.). Therefore, the following article will give a summary of the different types of enteral feeding tubes and their range of application. Additionally, a critical look on indication and contraindication is given as well as how to insert an enteral feeding tube.

Unintended Adverse Effects of Enteral Nutrition Support

“…It may be that our answer options were sufficiently covering the main complaints of ENS. Our adverse effects were similar to the reported complications in literature (1,5,7,10,13,14,21,32). As questionnaires were filled out online, there was no face-to-face contact.…”

“…ENS ensures nutritional supply by the use of a transnasal or percutaneous feeding tube (5). Common reasons for ENS are extreme prematurity, genetic diseases, transplantations, and oncologic diseases (4,(7)(8)(9). In addition to the positive benefits of ENS, literature also provides some evidence of unintended adverse effects of tube feeding.…”

“…Complications related to the feeding tube are reported either during the phase of tube placement or maintenance. Frequently described physical problems of nasogastric (NG) tube placement include the risk of misplacement and dislocation, bleeding, aspiration, oesophageal or pulmonary perforation, and nasopharyngeal discomfort (5,7,10). On the contrary, PEG tube placement is associated with a higher risk of infections, bleeding, dislocation and perforation of the feeding tube, wound healing delay around the placement site, tube blockage, balloon rupture, skin irritation, inflammation, and granulation tissue (5,7,10).…”

Komplikationen bei intensivmedizinischen Standardinterventionen

“…Faktoren für ein erhöhtes Risiko der Fehlanlage und Komplikationen von Ernährungssonden (nach [35,36]). Allgemeine Prinzipien der Intensivmedizin Tabelle 7 Komplikationen von Thoraxdrainagen (nach [57]).…”

Long‐term Outcomes of an Interdisciplinary Tube Weaning Program

“…However, despite all the positive and life-saving aspects of tube feeding, there are also some adverse effects, such as nausea, recurrent vomiting, regurgitation, aspiration, changes of osmolality, altered gastric emptying, abdominal bloating, chronic constipation or recurrent diarrhoea, and gastroesophageal reflux disease (GERD) (1,(3)(4)(5)(6)(7). The goal of transitioning to, or back to oral intake is of paramount importance when the medical problem, which led to the insertion of the feeding tube has been solved, or is at least stable, and the child is permitted to eat orally again.…”