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Enteral feeding in the critically ill: the role of the gastroenterologist.
Am J Gastroenterol. 2011 Jun; 106(6):1032-7; quiz 1038.AJ

Abstract

Expertise in enteral nutrition (EN) is an important aspect of the skill set of the clinical gastroenterologist. Delivery of adequate EN in critically ill patients is an active therapy that attenuates the metabolic response to stress and favorably modulates the immune system. EN is less expensive than parenteral nutrition and is favored in most cases because of improvement in patient outcomes, including infections and length of stay. Newer endoscopic techniques for placing nasoenteric feeding tubes have been developed, which improve placement success and efficiency. It appears that there is an ideal window period of 24-48 h when enteral feeding should be started in critically ill patients. Most patients can be fed into the stomach, but certain groups may benefit from small bowel feeding. Protocols on how to start and monitor enteral feeding have been developed. Immune-modulating feeding formulations also appear to be beneficial in specific patient populations. The gastroenterologist is a crucial member of the multidisciplinary team for nutritional support in the intensive care unit patient, with his knowledge of gastrointestinal pathophysiology, nutrition, and endoscopic feeding-tube placement.

Authors+Show Affiliations

Department of Gastroenterology, University of Utah Health Sciences, Salt Lake City, Utah, USA. john.fang@hsc.utah.eduNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

21468014

Citation

Fang, John C., and Mark H. Delegge. "Enteral Feeding in the Critically Ill: the Role of the Gastroenterologist." The American Journal of Gastroenterology, vol. 106, no. 6, 2011, pp. 1032-7; quiz 1038.
Fang JC, Delegge MH. Enteral feeding in the critically ill: the role of the gastroenterologist. Am J Gastroenterol. 2011;106(6):1032-7; quiz 1038.
Fang, J. C., & Delegge, M. H. (2011). Enteral feeding in the critically ill: the role of the gastroenterologist. The American Journal of Gastroenterology, 106(6), 1032-7; quiz 1038. https://doi.org/10.1038/ajg.2011.77
Fang JC, Delegge MH. Enteral Feeding in the Critically Ill: the Role of the Gastroenterologist. Am J Gastroenterol. 2011;106(6):1032-7; quiz 1038. PubMed PMID: 21468014.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Enteral feeding in the critically ill: the role of the gastroenterologist. AU - Fang,John C, AU - Delegge,Mark H, Y1 - 2011/04/05/ PY - 2011/4/7/entrez PY - 2011/4/7/pubmed PY - 2011/8/13/medline SP - 1032-7; quiz 1038 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 106 IS - 6 N2 - Expertise in enteral nutrition (EN) is an important aspect of the skill set of the clinical gastroenterologist. Delivery of adequate EN in critically ill patients is an active therapy that attenuates the metabolic response to stress and favorably modulates the immune system. EN is less expensive than parenteral nutrition and is favored in most cases because of improvement in patient outcomes, including infections and length of stay. Newer endoscopic techniques for placing nasoenteric feeding tubes have been developed, which improve placement success and efficiency. It appears that there is an ideal window period of 24-48 h when enteral feeding should be started in critically ill patients. Most patients can be fed into the stomach, but certain groups may benefit from small bowel feeding. Protocols on how to start and monitor enteral feeding have been developed. Immune-modulating feeding formulations also appear to be beneficial in specific patient populations. The gastroenterologist is a crucial member of the multidisciplinary team for nutritional support in the intensive care unit patient, with his knowledge of gastrointestinal pathophysiology, nutrition, and endoscopic feeding-tube placement. SN - 1572-0241 UR - https://www.unboundmedicine.com/medline/citation/21468014/Enteral_feeding_in_the_critically_ill:_the_role_of_the_gastroenterologist_ L2 - https://Insights.ovid.com/pubmed?pmid=21468014 DB - PRIME DP - Unbound Medicine ER -