Health & Medical stomach,intestine & Digestive disease

Enteral Feeding

Enteral Feeding
Purpose of Review: Enteral nutrition is now widely used as the preferred route of nutritional support in malnourished and intensive care unit patients. Studies providing evidence for efficacy, techniques of administration, and outcome are appearing daily in the literature. This review presents evidenced-based studies in this field from December 2002 to the present and critically reviews them for the reader. In this way the reader can rapidly access important publication from the morass being published each year.
Recent Findings: A diverse group of studies are covered in this review: effect of nutritional status on outcome, effect of combining enteral and parenteral nutrition, enteral nutrition in pancreatitis, rehydration of infants, gastric versus intestinal feeding, nutrition in hip fractures and pressure ulcers, systematic reviews and guidelines, immunonutrition and enterocolitis in infant feeding.
Summary: Enteral nutrition is an established modality of nutritional support that has received wide acceptance. It is not clear, however, for which conditions it improves patient outcome and the best way to optimize its delivery. In this review, articles addressing the outcome of patients and methods to optimize delivery of enteral nutrition are reviewed. Unfortunately, with few exceptions, most studies are based on few patients or do not have a placebo arm. An more important flaw in these studies is the nutritional status of the patient and need for support.

During the period December 2002 to the present, there were 11 402 publications on enteral nutrition (EN). From this morass of publications, the ones selected are evidenced based and provide new information. Unfortunately, most studies are based on small sample size and therefore are often difficult to interpret. In addition, most studies do not have a placebo arm and compare parenteral nutrition (PN) with EN. Even these studies are difficult to interpret because they do not address the nutritional status of the patient nor are they comparable in terms of nutrient intake, nor do they control for hyperglycemia, which is now recognized to be a major cause of complications.

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