The technique of administering enteral nutrition. Practical pointers for ensuring correct placement, avoiding complications.

Abstract

Many critically ill patients require nutritional support to avoid protein-calorie malnutrition. Enteral administration is preferred because it is less expensive than parenteral nutrition and is associated with fewer complications. Nasogastric insertion is the route most often used; however, oral insertion is required for intubated patients. Administration of a promotility agent increases the chances that the feeding tube will migrate transpylorically; it also improves gastric emptying. To lower the risk of aspiration, check the level of gastric residuum before initiating, or increasing the level of, nutritional support. Diarrhea is not an indication for stopping enteral nutrition.