Enteral nutrition

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Format: Buch
Sprache:English
Veröffentlicht: Philadelphia [u.a.] Saunders 1998
Schriftenreihe:Gastrointestinal endoscopy clinics of North America 8,3
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adam_text ENTERAL NUTRITION CONTENTS Foreword xiii Charles J. Lightdale Preface xv Moshe Shike and Abby S. Bloch Nasogastric and Nasoenteric Feeding Tubes 529 Howard Levy This article discusses the placement of nasogastric and nasoenteric feeding tubes using blind, pH, magnetic, sonagraphic, electromyo gram, fluoroscopic, and endoscopic assisted techniques. Bedside tests to ensure appropriate tube location are detailed. The complica¬ tions of inappropriately located tubes are listed, and methods to reduce adverse side effects are given. Percutaneous Endoscopic Gastrostomy . 551 Bassem Y. Safadi, Jeffrey M. Marks, and Jeffrey L. Ponsky Accessing the stomach via a gastrostomy is the preferred method for providing enteral nutritional support when supplementation is required for more than three or four weeks. Since its introduction in the early 1980s, percutaneous endoscopic gastrostomy has be¬ come the most popular method for creating a gastrostomy. It is a quick and cost effective method and has supplanted open gastros¬ tomy for the establishment of a gastrocutaneous fistula to provide access to the stomach for numerous indications. It is associated, however, with serious and potentially lethal complications which must be completely understood by the endoscopist. In addition, patient selection and thorough attention to details are paramount to the performance of a safe percutaneous endoscopic gastrostomy. GASTROINTESTINAL ENDOSCOPY CLINICS OF NORTH AMERICA VOLUME 8 NUMBER 3 JULY 1998 vii Direct Percutaneous Endoscopic Jejunostomy 569 Moshe Shike and Lianne Latkany Jejunal feeding often is preferable to gastric feeding, particularly in the following situations: high risk for aspiration; gastric resection (partial or total); gastric pull up; gastric outlet obstruction; ob¬ structed or nonfunctioning gastrojejunostomy; and gastric dysmo tility. The technique of placing a thin tube through a gastrostomy tube and pulling it endoscopically into the proximal jejunum allows delivery of nutrients into the jejunum. The results of this technique, however, have been poor. The direct percutaneous endoscopic jejunostomy technique allows placement of tubes directly in the jejunum with a success rate of around 85% and a minimal complica¬ tion rate which is comparable to that of PEGs. Surgical and Laparoscopic Techniques for Feeding Tube Placement 581 Keith Georgeson and Elizabeth Owings Surgeons have at their disposal multiple options for providing enteral access in a myriad of circumstances. This article reviews the techniques for surgical placement of enteral access as well as the indications, benefits, and complications for each procedure. The feeding tubes commonly available are described, and consider¬ ations involved in the choice of procedure are discussed. Enteral Feeding Solutions 593 Laura E. Matarese There has been a widespread proliferation of enteral feeding solu¬ tions for general and specific therapeutic use. This article reviews the nutrient substrates and physical characteristics of these solu¬ tions with consideration to both psychological and clinically proven principles pertinent to their application. The rationale for the composition and efficacy studies of disease specific solutions also is presented. Design and Production of Enteral Feeding Tubes 611 William H. Hirsch and Carl J. Piontek The evolution of enteral feeding via tubes, syringes, and other mechanical devices probably began in Egypt before the birth of Christ. Today s feeding tubes are a safe and effective means for providing long term feeding to patients unable to maintain sufficient nutrition by oral intake. The needs of enterally fed patients are presently being met with feeding tubes that are biocompatible, easy to use, and relatively inexpensive to manu¬ facture. viii contents Enteral Feeding in Critical Care, Gastrointestinal Diseases, and Cancer 623 Donald F. Kirby and J. Carlos Teran This article discusses the many advantages and changes that have occurred in the nutritional management of critically ill patients, patients with gastrointestinal diseases, and patients with selected cancers. Mechanical obstruction is the only absolute contraindica¬ tion to enteral nutrition. This article reviews the present aggressive approach to the use of enteral nutrition. Enteral Nutritional Support in Burn Patients 645 John F. Hansbrough Early and continued nutritional support has been determined to be an important component of therapy for seriously burned pa¬ tients. The hypermetabolic response to severe injury requires in¬ creased calorie and protein intake to blunt the catabolism and loss of lean muscle mass. Enteral feeding has been found to directly nourish the gastrointestinal tract and may help reverse the defective gut barrier which accompanies burn shock. In contrast, intravenous nutritional support appears to lack effectiveness in burn patients and may actually increase morbidity and mortality. Enteral Nutrition in the Pediatric Population 669 Valerie Marchand, Susan S. Baker, and Robert D. Baker Enteral feeding, the provision of liquid nutrients into the gastroin¬ testinal tract, is an important component of pediatric care. For the infant or child with a functioning or even a partially functioning GI tract, the use of the enteral route provides a safe and efficient means of delivering nutrition at a time of life when requirements are extremely high. In addition to high nutrient requirements in the early years of life, there are a number of specific pediatric conditions, such as failure to thrive, short bowel syndrome, and congenital heart disease, which place further demands on the grow¬ ing child. These demands can be met through the careful use of enteral feeds. This article reviews the physiology and practical application of enteral feeding to the pediatric age group. Outcome of Long term Enteral Feeding 705 Lyn Howard, Lynn Patton, and Roslyn Scheib Dahl In the past two decades, many technical advances have made tube enteral feeding much more comfortable and acceptable to patients and their families.! his has greatly expanded the use of this therapy, both in clinical conditions where it was traditionally prescribed and in many other diagnoses. This expanded use raises important questions about how much enteral nutrition is being used, the medical outcome in different clinical conditions, and the quality of life experienced by long term therapy users. This article addresses these outcome issues for patients in the nonhospital setting. CONTENTS IX Ethical Issues in Instituting and Discontinuing Enteral Feeding 723 Virginia M. Herrmann and Patrick F. Norris The shift from inpatient care has not lessened the importance of ethical issues in caring for patients. Dilemmas involving withhold¬ ing and withdrawing enteral nutrition require input from the pa¬ tient, family, and caregivers. Decisions to forego or discontinue treatment such as home enteral support should never be distin¬ guished from the responsibility of providing support and compas¬ sionate care throughout life, even during dying. Cost and Cost Benefit of Enteral Nutrition 733 Karen L. Goff Enteral nutrition is a therapy provided routinely in the hospital, extended care, and home care settings for patients who are unable to maintain adequate oral nutrition yet have a functioning gastroin¬ testinal tract. Information about the cost and effectiveness or bene¬ fits of enteral nutrition in the hospital and home care settings is important to know when making decisions about providing this therapy. This article discusses the methods used in cost analysis, explains the difference between cost and charges, and reviews the current information known about the cost effectiveness and cost benefits of enteral nutrition in the acute care setting and at home. Index 745 Subscription Information Inside back cover X CONTENTS
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physical XIV S., S. 529 - 749 Ill., graph. Darst.
publishDate 1998
publishDateSearch 1998
publishDateSort 1998
publisher Saunders
record_format marc
series Gastrointestinal endoscopy clinics of North America
series2 Gastrointestinal endoscopy clinics of North America
spellingShingle Enteral nutrition
Gastrointestinal endoscopy clinics of North America
Alimentation entérale
Enteral feeding
Sondenernährung (DE-588)4055511-2 gnd
subject_GND (DE-588)4055511-2
(DE-588)4143413-4
title Enteral nutrition
title_auth Enteral nutrition
title_exact_search Enteral nutrition
title_full Enteral nutrition Moshe Shike ... guest ed.
title_fullStr Enteral nutrition Moshe Shike ... guest ed.
title_full_unstemmed Enteral nutrition Moshe Shike ... guest ed.
title_short Enteral nutrition
title_sort enteral nutrition
topic Alimentation entérale
Enteral feeding
Sondenernährung (DE-588)4055511-2 gnd
topic_facet Alimentation entérale
Enteral feeding
Sondenernährung
Aufsatzsammlung
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