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Options for Nutrition in the Hospitalized Patient

Enteral vs. Parenteral Nutrition

Rafael Barrera, MD, Director, Surgical ICU at LIJ Medical Center, discusses patient nutrition and the three methods available to do so: oral (supplements), parenteral nutrition (PN) and enteral nutrition (PN). Parenteral nutrition can be central (TPN) or peripheral (PPN). He describes the simple principal of feeding the patient parenterally when there is no access to the GI tract.

The indications for PN are high-output fistulae, small bowel resections, and severe malnourishment where EN is not possible.

TPN is normally commenced when the patient has gone 10 days without nutrition.If there is access to the GI tract, the patient should always be fed enterally with NG tubes, PEGS etc.

Reading:
Calder PC.Rationale and use of n-3 fatty acids in artificial nutrition.Proc Nutr Soc. 2010 May 5:1-9.
Volkert D, Saeglitz C, Gueldenzoph H, Sieber CC, Stehle P.Undiagnosed malnutrition and nutrition-related problems in geriatric patients.J Nutr Health Aging. 2010;14(5):387-92.
Mueller M, Lohmann S, Thul P, Weimann A, Grill E.Functioning and health in patients with cancer on home-parenteral nutrition: a qualitative study.Health Qual Life Outcomes. 2010 Apr 16;8:41.

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