Tube Feeding Syndrome in Head and Neck Surgery

Nutrition Therapy, Glucose Control, and Brain Metabolism in Traumatic Brain Injury: A Multimodal Monitoring Approach

“…Additionally, the type of lipid to be offered in TBI is important since omega-6 fatty acids, mainly arachidonic acid derived from linoleic acid, modulate innate immunity and are inflammatory (series 2 and 4 eicosanoids), while omega-3 fatty acids (series 3 and 5 eicosanoids) can counterbalance the inflammatory effects of omega-6 fatty acids and favorably modulate the innate immunity involved in inflammation. Thus, the n-3 polyunsaturated fatty acids (PUFAs), eicosapentaenoic (EPA) and docosahexaenoic (DHA), when released from the plasma membrane phospholipids in the process of TBI are converted into resolvins and protectins (e.g., neuroprotectin D1), which actively promote resolution of inflammatory processes by downregulating the NF-κB pathway and promoting the clearance of neutrophils, activating synaptic plasticity and cytoskeletal assembly, respectively (Walike, 1969) (see Figures 1, 2).…”

“…Patients with acute TBI are frequently exposed to hyperosmolar fluids, such as hypertonic saline, which has gained significant interest in current neurocritical therapy because they are devoid of dehydrating properties and have several other beneficial advantages, such as increasing cardiac output, decreasing peripheral vascular resistance and afterload, increasing antiinflammatory properties and increasing intravascular volume (Rhoney and Parker, 2006;Cook et al, 2008;van der Jagt, 2016). Therefore, clinicians must be aware of the quantities and concentrations of protein and sodium being administered for patients on EN because the intake of large amounts of protein and insufficient water, with a moderate intake of sodium, may constitute the main cause of Tube Feeding Syndrome (Hypernatremia, Azotemia, and Dehydration) (Gault et al, 1968;Walike, 1969).…”

Age Differences in Fluid Balance and Serum Na+ and K+ Levels After Nasogastric Tube Feeding in Stroke Patients: Elderly vs Nonelderly

“…However, it has been persistently reported that hyper-osmolar feeding may cause dehydration and hypernatremia development, especially in the elderly, because they have a reduced renal concentrating ability and thus excrete more water in urine. 18 Recently, iso-osmolar feeding formulas have been favored by clinics. Most subjects in the present study were also provided iso-osmolar feeding formulas, and this probably contributed to the lower incidences of dehydration and hypernatremia observed.…”

“…This high incidence rate of overhydration in stroke patients might be due to increased ADH secretion, which is frequently observed in stroke patients due to brain injury or to the adoption of a continuous supine position. 18,21 Moreover, stroke patients commonly receive medications favoring sodium loss and water retention in the acute stage.…”

Effects of Nasogastric Tube Feeding on Serum Sodium, Potassium, and Glucose Levels

“…The prevalent metabolic complications of nasogastric tube feeding are hypernatremia, hyponatremia, and hyperkalemia (Cataldi‐Betcher, Seltzer, Slocum, & Jones, 1983; Gormican, Liddy, & Thrush, 1973; Pancorbo‐Hidalgo, Garcia‐Fernandex, & Ramirez‐Perez, 2001; Vanlandingham, Simpson, & Daniel, 1981; Walike, 1969). Hyperglycemia has also been frequently reported to be a complication of tube feeding (Pancorbo‐Hidalgo et al, 2001).…”