ENTERAL AND PARENTERAL FEEDINGS

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ENTERAL AND PARENTERAL FEEDINGS
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TUBE FEEDING
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ENTERAL NUTRITION

• Definition
• Feeding via tube into the gastrointestinal tract
  (GIT), bypassing the oral cavity, esophagus and,
  if needed, the stomach.
• Indications
• When patient cannot or will not eat enough but
  GIT is still functional
• Examples oral ulcers, obstructions, dysphagia,
  surgical procedures, anorexia nervosa

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TF

• Types placement determines type of TF used
• Nasogastric
• Nasoduodenal
• Gatrostomy
• Jejunostomy

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TUBE FEEDINGS NON SURGICAL
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TUBE FEEDINGS-SURGICAL
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REQUIREMENTS

• Nutritionally complete
• Varying caloric levels depending on tube feeding
  must meet individual needs
• Increase calorie content?increase viscosity
• CHO, PRO, FAT to meet energy needs
• Density
• Vitamins and minerals
• With or without fiber
• Lactose free

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SPECIALTY FORMULAS

• Stress, pulmonary, pediatric, liver, renal
• Modular formulas
• Carbohydrates
• Proteins
• Lipids

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ADMINISTRATION

• Bolus
• Gravity
• Intermittent
• Continuous

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COMPLICATIONS

• Clogging
• Aspiration
• Drug incompatibility
• Nausea and vomiting
• Diarrhea or constipation
• Infections
• Contaminated formula

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IF THE GUT WORKS, USE IT!
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PARENTERAL NUTRITION

• Peripheral parenteral nutrition
• Short term
• Partially meets nutritional needs

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PERIPHERAL PARENTAL NUTRITION
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PARENTERAL NUTRITION

• Total parenteral nutrition
• Long-term
• Nutritionally complete

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TPN
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INDICATIONS

• Inability to use the GIT
• Hypermetabolism
• Others

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REQUIREMENTS

• Can be tailored to meet individual needs
• CHO or CHO and fat for calories
• Protein (AA) to meet nitrogen needs
• Vitamins, minerals
• Unique nutrients placed directly into blood
  stream no gut control

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COMPLICATIONS

• Infection
• Gastrointestinal atrophy
• Refeeding
• Bacterial translocation