Enteral and Parenteral Nutrition

When patients have problems with eating or digestion. The next alternative is Enteral and Parenteral nutrition. So artificial foods are provided, to the patient, which is specially formulated to provide the right balance of fats, proteins, carbohydrates, vitamins and minerals. These artificial preparations can be delivered into the gut to be absorbed in usual way, known as Enteral Nutrition. Alternatively, they may be delivered into blood stream to bypass the gut, known as Paranteral Nutrition

Enteral Nutrition

Enteral Nutrition is refers to feeding through the gastrointestinal tract via tube and catheter that delivers nutrients distal to the oral cavity.

Conditions in which Enteral Nutrition is needed:

If the gut is working normally to absorb food and nutrients, then Enteral Nutrition is the preferred way of delivering Nutritional support. It is recommended in following conditions:

  • Patients with altered mental status.
  • Swallowing difficulty.
  • Disorder of upper gastrointestinal tract that can be bypass by inserting a feeding tube below the dysfunction.

Advantages:

Research supports the use of Enteral Nutrition because of following advantages:

  • Cost effective
  • Reduced hospital length of stay
  • Reduced surgical intervention
  • Reduced rate of infectious complications in critically ill patients
  • Improved wound healing
  • Maintenance of gastrointestinal function

Disadvantages:

Disadvantages of Enteral feeling include the potential difficulty of administration, poor tolerance and difficulty of meeting nutrition requirements of some patients.

These disadvantages can be minimized by careful patient selection, through nutrition focused physical assessment and use of standardized protocols.

Parenteral Nutrition:

The word “parenteral” means bypass the gastrointestinal tract, and administration of nutrients by vein is called Parenteral Nutrition.

Conditions in which parenteral Nutrition is required:

If the patient is unable to meet nutritional needs either by an oral diet or through the use of enteral nutrition.

Clinical conditions that may require parenteral nutrition include:

  • Inability to digest or absorb nutrients
  • Short bowel syndrome
  • Intractable vomiting
  • Gastrointestinal tract obstruction
  • Impaired gastrointestinal motility
  • Abdominal trauma, injury or infection

Parenteral nutrition is slowly pumped into the blood stream through a drip. As it can be very irritant to blood vessels. It is normally given into a large vein near the heart through a central venous line placed into the upper arm, chest or neck. Using parenteral nutrition can sometimes results in serious problem such as blood infections or an upset in biochemistry. Therefore, patients needed intensive monitoring during parenteral nutrition.

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