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Enteral Nutrition Diet - Essay Example

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In this essay, indications, scientific rationale, restrictions for the feeding and teaching plan for the feeding will be discussed through review of current research pertaining to enteral feeding. Severely ill patients admitted to critical care unit are in a hypercatabolic state and protein energy malnutrition is a major problem in them. Research has shown that early initiation of feeds enterally, is beneficial and has many advantages like decrease in complications due to sepsis and improved outcomes (DeB et al, 2001). This is because; enteral nutrition preserves the mass of the gut, prevents permeability of the gut to bacteria and their toxins, and preserves the lymphoid tissue of the gut (Binnekade, 2005). Enteral feeding has gained immense popularity because of lower rate of complications with the procedure and also lower cost involved (Binnekade, 2005). Early initiation of enteral feeding has been made a standard protocol in several intensive care units. Because of these protocols, the incidence of enteral feeding has increased dramatically. Malnutrition is not only a cause, but also a consequence of poor health. It makes the individual vulnerable to infection, causes delay in wound healing, impairs the function of lungs and heart, causes depression and decreases the strength of the muscles. In general patients with malnutrition have higher mortality and morbidity rates. In surgical patients, those with malnutrition have 3 times increased risk of complication. They also have increased

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mortality rates, with risk being 4 times those without malnutrition. Persistence of poor eating and inability to properly feed for several weeks can cause death by itself (NICE, 2006). Enteral feeding must be initiated in patients who are either malnourished or at risk of malnourishment and are either unable to take sufficient nutrition or oral intake is unsafe. At the same time, the gastrointestinal tract must be accessible and functional. It should not be initiated in those who are not malnourished. According to NICE guidelines (2006), "surgical patients who are: malnourished and have; inadequate or unsafe oral intake and a functional, accessible gastrointestinal tract and are due to undergo major abdominal procedures, should be considered for pre-operative enteral tube feeding." NICE (2006) recommends that in general surgical patients, enteral feeds must not be initiated within 48 hours after surgery unless they suffer from malnourishment or are at definite risk of malnourishment. Several types of tubes have come up for establishing enteral tubes. The choice of tubes depends on the expected duration of feeding, condition of the patient and the anatomy of the gastrointestinal tract of the patient. The most frequently used tubes are nasogastric tubes. Other tubes include nasojejunal tubes and nasoduodenal tubes. In some patients, tubes may need to be inserted through gastrostomy or jejunostomy, either through radiological, endoscopic or surgical means and tubes for such purposes are different (Bourglat et al, 2007). Nasogastric tubes are mainly employed for feeding patients for a short duration of time and those who do not have problems like gastroesophageal reflux, vomiting, poor gastric emptying, intestinal obstruction and ileus. Use of these tubes for feeding is dangerous in patients who have unsafe swallow and in those who need to be

Summary

Enteral Feeding Patients admitted to critical care units are more often than not malnourished either because of their disease process or due to decreased intake of nutritious diet, or both. Malnourishment in these patients is dangerous and contributes to several complications which increase the mortality and morbidity rate (Binnekade et al, 2005)…
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