The Evolution of Feeding-Decompression: Automatic Monitoring and Control of Inflow

摘要

"Feeding intolerance" frustrates attempts to enterally nourish patients with marginal gut function. Decompression catheters provide proximal aspiration, removing digestive juices and gas in an effort to mininiize this iatrogenic complication. We now add automatic "checking for residual" every minute at the enteral feeding site. Total inflow (feedings plus digestive secretions) is limited to exactly match impaired peristaltic outflow. All air and excess foodstuff are removed by the Moss? tube, with return of the degassed aspirate. The earliest stage of "feeding intolerance" is fluid accumulation at the enteral feeding site. Full feeding now can be initiated safely in the face of impaired GI function. The potential excess can be removed before distention and vagal reflexes further disrupt the sluggish gut. Adding monitoring and refeeding to the current feeding-decompression regimens results in earlier enteral nourishment for patients with critically impaired gut function. Their feeding goals can be safely approached and achieved immediately postoperatively.