Guidelines for enteral feeding in adult hospital patients

Stroud, Mike; Duncan, Hamish D.; Nightingale, J. M. D.

doi:10.1136/gut.52.suppl_7.vii1

Cited by 287 publications

(299 citation statements)

References 73 publications

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“…Detailed guidelines for this are available [17]. In short, the following principles have to be followed.…”

Section: Principles Of Enteral Nutritionmentioning

confidence: 99%

Nutritional support in gastrointestinal surgery: an overview

Lakshman

2008

Indian J Surg

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Nutritional status is important in determining the outcome of surgical patients. This is particularly so in patients undergoing gastrointestinal (GI) surgical procedures. It is important for the GI surgeon to be always aware that he has to assess the nutritional status of his patient, provide supplementation when required and have the means to get enteral and/or parenteral access when required. He must have the knowledge to choose the right route and formula for nutritional support. This evidence-based review gives an overview of the subject with the purpose of increasing awareness about the science of surgical nutrition.

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“…Detailed guidelines for this are available [17]. In short, the following principles have to be followed.…”

Section: Principles Of Enteral Nutritionmentioning

confidence: 99%

Nutritional support in gastrointestinal surgery: an overview

Lakshman

2008

Indian J Surg

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“…Gastrointestinal complications include abdominal bloating, and cramps can result from delayed gastric emptying, intestinal obstruction and fermentation of the diet [21][22][23]. Diarrhoea occurs commonly due to multiple factors, including prolonged antibiotic use, concomitant medications (H 2 antagonists, antacids, chemotherapy and laxatives), altered bacterial flora, formula osmolality, method or rate of infusion, lactose intolerance and bacterial contamination of formulas and delivery systems [24][25][26].…”

Section: Introductionmentioning

confidence: 99%

Study of Feeding Jejunostomy as an Add on Procedure in Upper Gastrointestinal Surgeries

Shenoy

Adapala

2013

Indian J Surg

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Jejunostomy is usually indicated as an additional procedure during major surgery of upper digestive tract to administer enteral nutrition in post-operative period. Complications associated with it can be mechanical, infectious, gastrointestinal or metabolic. The aim of the study was to evaluate safety of post-operative feeding jejunostomy in different types of major upper gastrointestinal surgeries. It was a prospective study conducted during the period between August 2009 and September 2011. Post-operative cases of major upper gastrointestinal surgeries who receive jejunostomy feeds were included in the study. Sampling was done by convenient method with sample size of 50 cases. Post-operatively, patients were monitored according to standard orders of enteral nutrition. Total calorie and protein intake through feeding jejunostomy was calculated regularly, and complications were assessed in terms of frequency, type, duration, management, and final outcome in different types of upper gastro intestinal surgeries. Analysis was done using chi square test with the help of statistical package SPSS vers.13. P < 0.05 was considered as significant. Complications observed were gastrointestinal −8 (16 %), mechanical −6 (12 %), infectious −4 (8 %) and metabolic −4 (8 %). Duration of complications ranged from 1 to 7 days (mean, 4 days). All types of complications observed during study were less severe and could be managed by simple measurements. Haemoglobin, serum albumin and weight of the patient at the time of discharge were improved for all patients when compared to pre-operative values. All patients received target calories and proteins through feeding jejunostomy. Considering benefits of enteral feeding via jejunostomy tube with minor and acceptable complications, we conclude that feeding jejunostomy is a preferred route of nutritional administration in those who undergo major upper gastro intestinal surgeries.

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“…In contrast to metoclopramide, domperidone is a peripherally acting dopamine antagonist, which avoids the central nervous side effects and thus, has little extra-pyramidal adverse effects. Whilst these agents have been reported to improve gastric emptying in these patients, its efficacy in improving feed intolerance remains controversial [7][8][9] . The effect of metoclopramide on the gastric residual volume (GRV) was not observed after an enterally administered 10 mg dose, and not after the third dose, a modest reduction in GRV was detected [7][8][9] .…”

Section: Dopamine Agonistsmentioning

confidence: 99%

“…Prokinetic agents are currently considered as the firstline therapy for feed intolerance given issues relating to parenteral nutrition and post-pyloric feeding [7][8][9] . In addition to the technical difficulties related to the placement of post-pyloric feeding tube, the morbidity and mortality benefits of post-pyloric feeding have not been demonstrated in these patients, especially in those who do not have impaired gastric emptying, and thus, routine use of post pyloric feeding is not recommended [10][11][12] .…”

Section: Introductionmentioning

confidence: 99%

Pharmacological therapy of feed intolerance in the critically ills

Nguyen¹

2014

WJGPT

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Feed intolerance in the setting of critical illness is associated with higher morbidity and mortality, and thus requires promptly and effective treatment. Prokinetic agents are currently considered as the first-line therapy given issues relating to parenteral nutrition and postpyloric placement. Currently, the agents of choice are erythromycin and metoclopramide, either alone or in combination, which are highly effective with relatively low incidence of cardiac, hemodynamic or neurological adverse effects. Diarrhea, however, can occur in up to 49% of patients who are treated with the dual prokinetic therapy, which is not associated with Clostridium difficile infection and settled soon after the cessation of the drugs. Hence, the use of prokinetic therapy over a long period or for prophylactic purpose must be avoided, and the indication for ongoing use of the drug(s) must be reviewed frequently. Second line therapy, such as total parenteral nutrition and post-pyloric feeding, must be considered once adverse effects relating the prokinetic therapy develop.© 2014 Baishideng Publishing Group Inc. All rights reserved. Key words: Adverse effects; Critical illness; Enteral feeding; Feed intolerance; Prokinetic therapyCore tip: Feed intolerance during critical illness must be promptly recognized and treated due to the associated morbidity and mortality. The current first line treatment for feed intolerance is prokinetic therapy with erythromycin and metoclopramide (alone or in combination), which are highly effective and free of significant adverse effects. Although diarrhoea occurs commonly after combination prokinetic therapy, it is not associated with Clostridium difficile colitis and settled shortly after stopping the treatment. The use of prokinetic therapy over a long period or for prophylactic purpose, therefore, must be avoided and the indication for ongoing use of the drug(s) should be frequently reviewed.Nguyen NQ. Pharmacological therapy of feed intolerance in the critically ills.

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Guidelines for enteral feeding in adult hospital patients

Cited by 287 publications

References 73 publications

Nutritional support in gastrointestinal surgery: an overview

Nutritional support in gastrointestinal surgery: an overview

Study of Feeding Jejunostomy as an Add on Procedure in Upper Gastrointestinal Surgeries

Pharmacological therapy of feed intolerance in the critically ills

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