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.

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