The Role of Enteral Nutrition in the Treatment of Critically Ill Patients

Overview

The positive role of enteral nutrition (EN) is widely accepted in the treatment of critically ill patients. Enteral nutrition support induces in a significantreduction of infectious complications and reduces the overall hospital stay. EN saves gut barrier function, enhances gut blood flow and IgA secretionon bronchial and mucosal surface in experimental animal studies. On the other hand, the application of EN may not safe for critical care patients. Themain danger of EN is development of malnutrition, regurgitation and aspiration of nutrients. The late diagnosis of gut dysfunction is characterised bygut distension, hemodynamic instability and ventilatory alteration. We conclude that the gastric application of nutrition is more safe for critically illpatients, because the manifestation of eventually existing gut dysfunction is earlier. The monitoring of gastric nutrition tolerance must be frequent.The combination of EN with parenteral nutrition is useful in prevention of malnutrition. The possibility to feed critically ill patients only through thegut is described in more than 50%.

Key words:
enteral nutrition - parenteral nutrition - intensive care - critical care