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  3. McGill University (Mcgillu)
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  5. Nutrition And Dietetics
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  7. Clinical Nutrition 2 (NUTR545)

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Enteral Nutrition Notes

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Comprehensive notes for Clinical Nutrition 2 class. First topic: Enteral nutrition. Based on class notes, teacher's slides and textbook readings. Content clearly summarized in bullet points but with enough details. Relevant charts and diagrams included. Ended up doing very well in the class.

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  • January 20, 2019
  • 16
  • 2018/2019
  • Study guide

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Enteral Nutritinn ASPEN Chapter 10-13 + Alide Aet #1

 Definitii if iutrnitii suppirt
o The privnisniii if iral, eterial ir pareiteral iutrnitii ti treat ir preveit
maliutrnitii aid maniitaniirrestire iptmal iutrnitiial status aid health

 Iidnicatiis if Nutrnitii Suppirt
o Iiadequate iral niitake fir 7-14 days
o Altered GI fuictii
o Dysphagnia (ex caused by strike ir ither ieurilignic dnisease)
o PEM
o Iicreased iutrnieit ieed that cai’t be met irally (ex pist trauma)
o Sniginifcait niiviluitary wenight liss

 Selectig a feedniig riute




 Definitii if EN
o Nutrnitii privnided thriugh the GI tract vnia a tube, a catheter, ir stima
that delnivers iutrnieits dnistal ti the iral cavnity

 Iidnicatiis if EN
o Pateits wnith a fuictii GI tract AND
o Uiable ti meet iutrnitiial ieeds irally (<50%) fir 7-14 days ir expected
iit ti meet them fir at least 7-14 AND
o Are hemidyiamnically stable (MAP at least 50-55) (stable BP aid
ciisnisteit fiw if bliid thriughiut the bidy)
o IBD, GERD, PEM, dysphagnia, majir surgery, trauma, caicer, buris,
ieurilignical dnisirders, CVA

 Beiefts if EN
o Primites efficnieit utlnizatii if iutrnieits (uidergi frst-pass metabilnism)

, o Stmulates release if CC frim gallbladder maniitanii priper gall bladder
fuictii, preveitig chilecystts
o Maniitanii GI structure, niitegrnity aid fuictii
o Eihaices niitestial nimmuie fuictii (IgA)
o Reduces rnisk if bacternial traislicatii  reduces niifectii rnisk
o Reduces leigth if hispnital stay
o Cist-effectve

 Ciitraniidnicatiis if EN
o Sever shirt biwel syidrime (<100 cm)
o Mechainical GI ibstructii
o Iitractable vimnitig aidrir dniarrhea
o Paralytc nileus
o Dnistal hnigh iutput GI fstula (>500 mlrday)
o Sever malabsirptve ciidnitiis
o Iiabnilnity ti ganii access ti GI tract
o Pallniatve care
o Shirt supply perniid: <5-7 days nii maliiurnished ir <7-9 nii iiurnished pts.

 Selectig ai EN access riute




 Dniffereit access riutes fir EN tubes
o Thriugh the iise: iasigastrnic, iasiduideial, iasijejuial
o Gastristimy: PEGrPRG, PEJrPRJ, PEGrJ, surgnically placed gastristimy
o Jejuiistimy

,  PEG
o Eidiscipnic pricedure nii whnich a tube nis passed niiti a pateit’s stimach
thriugh the abdimniial wall
o Iidnicatiis: niiabnilnity ti mive fiid frim miuth ti stimach ex
ieurilignical dnisirders, caicer, upper GIT surgery
o Ciitraniidnicatiis: severe ascnites, severe gastriparesnis, ciagulipathy,
gastrnic varnices (upper GI hemirrhage), ieiplastc ir niifammatiry
dnisease if the abdimniial wall

 Firmula selectii ciisnideratiis
o Age (niifait, pedniatrnic, adult)
o Hispnital firmulary
o Nutrnitiial requniremeits
o Dnigestii aid absirptii
o Mednical ciidnitii
o Duratii if EN
o Cist

 Types if firmula
o StaidardrPilymernic: niitact pritenii, carbs aid fat
o ElemeitalrSemni-elemeital: cimpletelyrpartally dnigested iutrnieits
(priteniis as free AAs ir peptdes, snimple sugar aid glucise pilymers, fat
prnimarnily as MCT)
o Dnisease-specnifc
o Midular cimpiieits cai be added ti eihaice iutrnieit ciiteit if a
firmula. Ex. Pritenii piwder.
 Staidard firmula

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