Malnourished patients should be considered for enteral feedings. If the patient cannot maintain an adequate intake, the enteral feedings can be a life-saving procedure. Critically ill patients, post-operative patients that can only take limited amounts, and patients with problems such as severe pancreatitis, may require some assistance with nutrition in order to get better. There are instances when the enteral feedings are given along with the parenteral nutrition. This is done in order to reduce the likeliness of cholestasis and to maintain the gut function. Different routes are available for achieving this feeding. Nasogastric tubes are the most common form of delivery and are easy to insert. These tubes must be checked routinely because all though they are easy to insert they are also easy to become displaced.
Peg tubes are more common with patients that have had a stroke, Parkinson’s disease, motor neurone disease or esophogeal cancer. These tubes are inserted surgically directly through the stomach wall. There is a form of this tube that is referred to as the percutaneous jejunostomy tube. This tube is inserted through the stomach into the jejunum, using a surgical technique.
After the tube is inserted and the orders are received by the physician, you will need a feeding set, in order to start the feedings. One type of this is the gravity feeding set. This set will hold 1200ml and comes with a drip chamber, roller clamp, hanger, and a top-fill opening. This bag is leak proof and cuts down on formula spills and also waste. They come 30/case. A different type of tubing is the EnteralLife Infinity set. It comes with a 500ml delivery set and is compatible with the EnteralLife pump. This set has a large top fill opening and is leak proof. These sets do require an enteral infusion pump to operate and come 30/case.
The type and amount of the enteral feeding is usually ordered by the physician or in some cases, the physician will order for the dietician to regulate the enteral feedings. Oral, enteral, or parenteral nutritional support should be considered for any patient that is malnourished or at risk or becoming malnourished. Potential swallowing problems should always be taken into consideration when making the determination as to the route of the nutrition.
One of the complications that can arise from these feedings is infection from contamination of the enteral feeding. The feeding sets and feeding should be discarded every 24 hours to minimize the risk of bacteria growing. Other complications can include the erosion or displacement of tubes, reflux, and aspiration. Enteral feedings can be highly beneficial to the malnourished patient. Assess the patient per protocol and monitor the feeding, so that the patient will receive the correct amount of feeding safely.