Why, how, and to which part of the gastrointestinal tract should forced enteral feedings be delivered in patients?

摘要

This review is will discuss some of the practical issues that face physicians and nutrition teams trying to deliver nutrition support to critically ill patients. The same issues often arise in patients who are much less severely ill, but those patients have wider margins of safety and physiologic response, making the decisions less urgent or clinically relevant. For this reason, most of the studies testing the provision of enteral feedings have been generated in the critically ill setting. Nonetheless, many of the issues discussed below are germane to all patients receiving forced enteral feeding. The survey makes no claims to be comprehensive, but to highlight issues that commonly involve practical decisions. The selection of the type of enteral feeding solution, however, is beyond the scope of this discussion. Many of the references are to systematic reviews or meta-analyses. Although the individual papers themselves have been examined, the bibliography would become too lengthy, and most single studies do not provide uniquely useful data.