Enteral nutrition: techniques and indications

Enteral nutrition must be preferred to parenteral nutrition if case of inta ct digestive tract, Naso-gastric tubes are frequently used, particularly in enteral feeding. However, the use of nasoenteral tubes, i.e. naso-duodenal and naso-jejunal tubes, is expected to increase in the future, Their effic acy has been demonstrated in two specific cases: intensive care (post-opera tive or posttraumatic states), acute pancreatitis, A third potential use is in the replacement of a naso-gastric tube by a naso-jejunal tube in cases of frequent aspiration pneumonia related to a gastro-esophageal reflux. Gas tro- and jejunostomies have to be indicated when enteral nutrition is thoug ht to be used for more than one month. The insertion of a naso-gastric tube is generally performed by the nurse following medical guidelines and the i nsertion of a naso-jejunal tube is often done during an endoscopy by the ph ysician. The verification of the correct position of the tube should prefer ably be done with an X-ray confirmation. However, this is difficult to perf orm at home and the most frequent method for control is the clinical method by auscultation. Enteral nutrients are generally polymeric and infused wit h gravity without a peristatic pump excepted in children. In conclusion, te chnical improvements in enteral nutrition have led to a simple, cost-effect ive and low risk methods of treatment.