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Source: Kumpf VJ, Chessman KH. Enteral nutrition. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861§ionid=146076834. Accessed March 23, 2017.
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Enteral nutrition (EN) indicated in patients who cannot or will not eat enough to meet nutritional requirements.
Requires both a functioning GI tract to allow for nutrient absorption, and a safe method of enteral access.
Typically indicated for patients with a variety of conditions or disease states such as stroke, cancer, altered mental status, etc.
Contraindicated with mechanical obstruction, bowel ischemia, uncorrectable coagulopathy, active peritonitis, and necrotizing enterocolitis.
EN success may be challenged with:
Severe diarrhea.
Protracted vomiting.
Enteric fistulas.
Severe GI hemorrhage.
Intestinal dysmotility.
Advantages of EN over parenteral nutrition (PN):
Maintaining GI tract structure and function.
Fewer metabolic, infectious, and technical complications.
Lower costs.
Initiate EN within 24–48 hours of hospitalization for critically ill patients.
Delay EN until oral intake inadequate for 5–7 days in mild to moderately stressed, well-nourished patients.
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Enteral access.
Administration methods.
Continuous.
Cyclic.
Bolus.
Intermittent.
Initiation.
Formulations.
Provide essential nutrients, including macronutrients (eg, carbohydrates, fats, and proteins) and micronutrients (eg, electrolytes, trace elements, vitamins, and water).
Proteins: molecular form ...