definition
history
superiority
path
indicate
Taboo symptom
Complications of tube feeding and its prevention and treatment
Matters needing attention
[Edit this paragraph] Definition
Enteral nutrition (EN) is a kind of nutritional support, which provides nutrients and other nutrients needed for metabolism through the gastrointestinal tract.
[Edit this paragraph] History
The development of providing nutrition through nasogastric tube was mainly seen at the end of 18, and it was widely used in 19 century. Nutramigen, the earliest enteral nutrition preparation, was listed on 1942 for the treatment of intestinal diseases in children.
The improvement of chemical formula mainly benefited from the development of aerospace industry in 1950s and 1960s. The formula has clear chemical composition, no residue, and can be absorbed without digestion, which is an essential diet. The application results show that normal people only need this element to maintain normal nutrition and physiological state within 6 months.
[Edit this paragraph] Advantages
With the in-depth study on the structure and function of gastrointestinal tract in recent years, people gradually realize that gastrointestinal tract is not only a digestive and absorptive organ, but also an important immune organ.
For this reason, compared with parenteral nutrition (PN), the advantages of EN are not only that nutrients are absorbed and utilized directly through the intestine, but also that it is more physiological, convenient for administration and low in cost, and it helps to maintain the integrity of intestinal mucosal structure and barrier function. Therefore, when deciding what kind of nutritional support to provide, it has become the common sense of many clinicians to choose en first.
[Edit this paragraph] mode
It depends on time, mental state and gastrointestinal function.
There are two ways of enteral nutrition: oral administration and catheter infusion, including nasogastric tube, nasoduodenum tube, nasojejunum tube and gastrojejunostomy tube.
[Edit this paragraph] Indications
Enteral nutrition should be used when the gastrointestinal function is normal and safe.
① Difficulty in swallowing and chewing
② Consciousness disorder or coma
③ Gastrointestinal fistula
④ Short bowel syndrome
⑤ Intestinal inflammatory diseases
⑥ Acute pancreatitis
⑦ Hypermetabolic state
⑧ Chronic wasting disease
Pet-name ruby correct and prevent malnutrition before and after operation.
Attend special diseases
[Edit this paragraph] Contraindications
Paralytic and mechanical intestinal obstruction, active gastrointestinal bleeding and shock are contraindications for EN. Severe diarrhea or severe malabsorption should also be used with caution.
[Edit this paragraph] Complications and prevention of tube feeding
(1) Mechanical failure
Reason: Its occurrence is often related to the feeding tube itself, such as the size and material of the tube diameter. Aspiration pneumonia is a potentially fatal complication, which may be caused by lower esophageal sphincter injury, large-diameter feeding tube displacement or improper posture.
Treatment: when nasal feeding, the patient's head should be raised by 30 degrees, and lh can be flat after washing; During nasal feeding, gastric residual fluid is pumped back, if it exceeds 100ml, nasal feeding should be suspended or the perfusion speed of nasal feeding should be slowed down.
(2) The feed pipe is blocked
Cause: The concentration of nasal feeding solution is too high or the homogenate is not completely broken.
Treatment: After nasal feeding, rinse the tube with water to ensure that there is no food residue in the tube.
(3) Gastrointestinal complications
Diarrhea is the most common.
Causes of diarrhea: long-term non-eating, initial nasal feeding, rapid perfusion, malabsorption, high concentration, lactose intolerance, etc.
Treatment: the first low concentration began, gradually increasing the concentration and slowing down the perfusion speed; For patients with lactose intolerance, lactose-free formula should be given.
(4) Abnormal metabolism
Such as dehydration, edema, potassium and high magnesium. Pay attention to observation and adjust the ingredients of the formula in time.
[Edit this paragraph] Precautions
Understand the composition and preparation method of diet
The total volume does not exceed 2000ml.
During tube feeding, the head and neck are raised.
After feeding the test tube, rinse the test tube with warm water.