Summary Hyperalimentation Detailed notes.

What is nutrition support?  An alternate means of providing nutrients to people who cannot eat any or enough food  When is it needed?  Illness resulting in inability to take in adequate nutrients by mouth  Illness or surgery that results in malfunctioning gastrointestinal tract  Two types:  Enteral nutrition  Parenteral nutrition Indications for Enteral Nutrition  Malnourished patient expected to be unable to eat adequately for 5-7 days  Adequately nourished patient expected to be unable to eat 7-9 days  Adaptive phase of short bowel syndrome  Following severe trauma or burns Contraindications to Enteral Nutrition Support  Malnourished patient expected to eat within 5-7 days  Severe acute pancreatitis  High output enteric fistula distal to feeding tube  Inability to gain access  Intractable vomiting or diarrhea  Aggressive therapy not warranted  Expected need less than 5-7 days if malnourished or 7-9 days if normally nourished Enteral Access Devices  Nasogastric  Nasoenteric  Gastrostomy  PEG (percutaneous endoscopic gastrostomy)  Surgical or open gastrostomy  Jejunostomy  PEJ (percutaneous endoscopic jejunostomy)  Surgical or open jejunostomy  Transgastric Jejunostomy  PEG-J (percutaneous endoscopic gastro-jejunostomy)  Surgical or open gastro-jejunostomy Feeding Tube Selection  Can the patient be fed into the stomach, or is small bowel access required?  How long will the patient need tube feedings?