URGENT FEEDING

5 Alternative Methods of feeding
ENTERAL FEEDING (Nasogasric or Gastric tube)
Patients with obstruction of upper GIT
Radiation loss of appetite
Full thickness skin burns
Major trauma
These patients will require enteral nutrition.
First because their calorific requirements cannot be met by parenteral feeds
Second those that have nutritonal needs that require long term replacement
The main energy providing constituents of enteral feeds are:

* Glucose or Triglycerides (sunflower seed oils)
Other constituents are:

* Electrolytes
* Minerals
* Trace metals
* And Vitamins

Some enteral feeds can be prepared to meet the specific needs of
Patients by the hospital nutrition departments.

Companies in the enteral food market now provide products that can
Be used to provide all the energy requirements or to supplement
Inadequate oral intake.

Enteral Feeding (Evidence Base)
Animal studies in burn trauma in rats, indicate early external feeding results in improved survival, a delay in feed by 24 hours, result in poor weights, and negative nitrogen balance.
It is suggested that external feeding in trauma restores, the immune / lymphoid tissue function thus maintaining survival, and clearance role, of the gut this protects the portal circulation and liver from bacterial invasion.
There is a body of opinion, that believes that glutamine availablelity, and uptake by the enterocyte for energy in the guts, has a large role to play in insuring the integrity of gut mucosa and its function.
The role of short chain fatty acids produced by colonic bacteria (colonocytes) from fermentation of pectin is another theory that supports enteral feeding 70% of the energy requirements of the coloncytes is derived from these short chain fatty acids a deficiency of these fatty acids threatens the integrity of colonic musosa barrier effect
Any questions be sent to drmmkapur@gmail.com
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