Introduction to enteral nutrition

Contents 1 Pinyin 2 English Reference 3 Overview 4 Indications 5 Methods and Contents 5.1 Types of Enteral Nutrition 5.2 Advantages 6 Precautions 7 Complications 8 References 1 Pinyin

cháng nèi yíng yǎng 2 English reference

enteral nutrition [WS/T 476—2015 Nutritional terms]

EN [WS/T 476—2015 Nutritional terms] 3 Overview

Enteral nutrition (EN) refers to a nutritional treatment method in which patients take nutritional preparations orally or through tube feeding to obtain the energy and nutrients needed by the body [1]. 4 Indications

1. Gastrointestinal fistula, duodenal fistula (administered from the jejunal orifice).

2. Short bowel syndrome.

3. Inflammatory bowel diseases, such as ulcerative colitis and Crohn's disease, in severe or acute attacks, total parenteral nutrition (TPN) should be used first, and after the small intestinal function is properly restored, Enteral nutrition was performed again.

4. Multiple trauma, fractures and severe burns.

5. For surgeries that require a low-residue diet, it can be used as preoperative bowel preparation and nutritional supplement before and after surgery.

6. Chronic malnutrition during radiotherapy and chemotherapy.

7. Pancreatitis or pancreatic fistula.

8. Indigestion and absorption.

9. As a supplement when peripheral intravenous nutrition is insufficient. 5 Methods and content

Enteral nutrition refers to the introduction of food or nutrient solution into the gastrointestinal tract through various tubes (such as nasogastric tube, gastric or jejunostomy tube). Good gastrointestinal absorption function is the basic condition for implementing enteral nutritional support. The nutrients input through the pipeline can be a liquid natural diet (including homogenized diet and mixed milk), or an elemental diet (diet) composed according to a certain formula, which contains various nutrients necessary for the human body. The nitrogen source material is an amino acid mixture or Protein hydrolyzate, energy substances are glucose, sucrose or polysaccharides and fats, etc. Some elemental diets also add medium-chain triglycerides that can be absorbed directly into the portal vein. 5.1 Types of enteral nutrients

1. Homogenized diet? It is a mixed diet made by processing and mixing natural foods into a homogenate. Generally, beef, pork liver, eggs, soy products, bread, fruit juice and other foods are used. It has comprehensive nutritional content. Because there is a lot of residue formed in the large intestine, it requires a certain length of intestinal tube with good absorptive function. Patients with gastrointestinal fistula and pancreatitis should use it with caution.

2. Mixed milk? Mix eggs, sugar, milk cake, flour and vegetable oil with water to make a paste, then slowly add it to boiled milk and soy milk. Slowly injecting 2000-2500ml/d through jejunostomy can meet the daily nutritional requirements of adults. The pros and cons are the same as for the homogenate diet.

3. Elemental diet (see table below)? Use it in a solution with a caloric density of cal/ml.

The composition of several plant-based diets (g/4180kJ (1000kcal)) Product name: Carbohydrates, fats, proteins, Vionex STD 266 (glucose and oligosaccharides) 1 (safflower oil) 21 (amino acid mixture) Vionex HN 210 (glucose and oligosaccharides) 1 (safflower oil) 42 (amino acid mixture) Vital 185 (glucose, oligosaccharides, polysaccharides) 10 (sunflower oil) 22 (soybean, whey hydrolyzate) Complex nutrients 205 (glucose, Dextrin) 2.25 (corn oil) 40 (fibrin, myocardial hydrolyzate) High-nitrogen mixture 175 (glucose, dextrin) 20 (corn oil) 48 (trypsin hydrolyzate) Huohuokang high-nitrogen 250 (glucose, dextrin ) 1.25 (corn oil) 40 (soy protein hydrolyzate) 5.2 Advantages

1. Nutrients are absorbed through the portal vein and transported to the liver, which is in line with physiology and is also beneficial to the synthesis and metabolism of liver proteins.

2. It can maintain the integrity of the intestinal mucosal cell structure and protect the intestinal mucosal barrier.

3. It is more conducive to the physical recovery of frail patients.

4. Easy to use and economical. 6 Precautions

Enteral nutrition generally starts with a small amount (<100ml), low concentration (8%), and continuous infusion for 8-12 hours, and then the volume, concentration and dosage are increased daily according to the patient's tolerance. Drip time. Enteral nutrition should not be used in the following situations:

1. Infants younger than 3 months old.

2. Paralytic or mechanical intestinal obstruction.

3. Severe intra-abdominal infection.

4. Patients with subtotal small bowel resection should be given total parenteral nutrition (TPN) support for 4-6 weeks after surgery, and then gradually given a vegetarian diet.

5. It should not be used in patients with intestinal fistulas whose functional small intestine at the distal end of the feeding tube is less than 100cm. 7 Complications

1. Gastrointestinal complications? Common ones include nausea, vomiting, abdominal cramps, diarrhea and bloating.

2. Metabolic complications? Increased blood sugar, hyperglycemic nonketotic dehydration, hypernatremia dehydration, hyperchloremia metabolic acidosis and electrolyte imbalance.