Although considerable clinical problems were solved by parenteral nutrition since 1960s, because of the risk of infectious and metabolic complications and advance in feeding tube placement, feeding methods, and artificial ingredient nutrients, enteral nutrition from 400 years ago has been brought to attention again. This review article is aimed to illustrate the issues related to enteral tube feeding in esophageal surgery.
Enteral Nutrition ; instrumentation ; methods ; Humans

Enteral Nutrition ; methods ; Humans ; Intestines ; pathology ; physiopathology

Enteral nutrition is the preferred way of clinical nutrition support, especially in critical ill patients. Establishment and maintenance of an appropriate way should be considered to ensure the safety and effectiveness of enteral nutrition support.
Critical Illness ; Enteral Nutrition ; methods ; Humans

Pediatric patients require specialized attention and have diverse demands for proper growth and development, and thus need a different approach and interest in nutritional assessment and supply. Enteral nutrition is the most basic and important method of nutritional intervention, and its indications should be identified. Also, the sites, modes, types, and timing of nutritional intervention according to the patient's condition should be determined. In addition, various complications associated with enteral nutrition supply should be identified, and prevention and treatment are required. This approach to enteral nutrition and proper administration can help in the proper growth and recovery of pediatric patients with nutritional imbalances or nutritional needs.
Child ; Enteral Nutrition ; Growth and Development ; Humans ; Malnutrition ; Methods ; Nutrition Assessment

Since it was described in 1980, percutaneous endoscopic gastrostomy (PEG) has been a widely used method for insertion of a gastrostomy tube in overseas patients who are unable to swallow or maintain adequate nutrition. PEG should be considered when enteral feeding is necessary for longer than 3-4 weeks in difficulty eating patients. However, this method is still not widely used in China. This article describes the indications and benefits of this method. Its possible risks, limitations, contraindications, and complications should also be considered in patients with severe diseases.
Enteral Nutrition ; instrumentation ; Gastroscopy ; methods ; Gastrostomy ; methods ; Humans ; Time Factors

Percutaneous endoscopic gastrostomy (PEG) is a well-established microinvasive procedure to provide enteral nutrition for various patients. Anesthetic intervention during PEG not only make patient feel painless but also help to guarantee the safety of patient by anesthetic monitoring. This article summarizes the recent advances in anesthetic techniques, drugs, and monitoring practices for patients under PEG.
Anesthesia ; methods ; Anesthetics ; administration & dosage ; therapeutic use ; Enteral Nutrition ; methods ; Gastroscopy ; methods ; Gastrostomy ; methods ; Humans

OBJECTIVETo assess the application of ultrathin transnasal gastroscopy in transnasal percutaneous endoscopic gastrostomy (nPEG) in patients with trimus and/or pharyngeal narrowing.

METHODSNine consecutive patients underwent PEG with the Introducer method using conventional gastroscopy (5 cases) or ultrathin transnasal gastroscopy (4 cases). Among the 4 patients undergoing nPEG, 3 received radiotherapy for nasopharyngeal cancer, including two with trimus and one with trimus and pharyngeal narrowing. The procedure time, safety, discomfort and complications in these cases were compared and evaluated.

RESULTSThe average procedure time of PEG was 17+/-3.5 min in conventional gastroscopy group and 17+/-3.1 min in nPEG group. No complications were observed in these patients, but the patients in nPEG group reported less discomfort associated with the procedure.

CONCLUSIONSUltrathin transnasal gastroscopy reduces the discomfort of the procedure and is safer than conventional gastroscopy for PEG, especially in patients with trimus and/or pharyngeal narrowing.

Aged ; Enteral Nutrition ; Female ; Gastroscopes ; Gastroscopy ; methods ; Gastrostomy ; methods ; Humans ; Male ; Middle Aged

PURPOSE: The purpose of this study was to investigate differences between a pulmonary aspiration group and a non-pulmonary aspiration group in glucose concentration of tracheal secretions by measuring time and feeding methods. METHOD: The subjects were 36 ICU patients who were receiving formula via nasogastric tubes and had endotracheal tubes or tracheostomy tubes. Tracheal secretions were collected by connecting suction traps to a suction catheter in three different times(within 1 hour after feeding, between 1 to 2 hours after feeding, and between 2 to 3 hours after feeding) for 2 days, overall six times. Glucose concentration of tracheal secretions was measured with the glucometer(Accucheck II). RESULTS: Glucose concentration of tracheal secretions increased in progression after feeding. The mean of specimens collected last(between two to three hours after feeding) was shown to be the highest value(M= 61.61 mg/dl) in the pulmonary aspiration group. Significantly(p=.000) more subjects(94.44%) in the pulmonary aspiration group received formula via a 50cc syringe than those in the non-pulmonary aspiration group(22.22%). CONCLUSION: Critically ill patients may need more time for head-elevation after tube feeding to prevent pulmonary aspiration. In practice, enteral formula should not be given the patients via a 50cc syringe anymore, instead a feeding bag or infusion pump should be used to prevent pulmonary aspiration.
Catheters ; Critical Illness ; Enteral Nutrition ; Feeding Methods* ; Glucose* ; Humans ; Infusion Pumps ; Suction ; Syringes ; Tracheostomy ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to investigate differences between a pulmonary aspiration group and a non-pulmonary aspiration group in glucose concentration of tracheal secretions by measuring time and feeding methods. METHOD: The subjects were 36 ICU patients who were receiving formula via nasogastric tubes and had endotracheal tubes or tracheostomy tubes. Tracheal secretions were collected by connecting suction traps to a suction catheter in three different times(within 1 hour after feeding, between 1 to 2 hours after feeding, and between 2 to 3 hours after feeding) for 2 days, overall six times. Glucose concentration of tracheal secretions was measured with the glucometer(Accucheck II). RESULTS: Glucose concentration of tracheal secretions increased in progression after feeding. The mean of specimens collected last(between two to three hours after feeding) was shown to be the highest value(M= 61.61 mg/dl) in the pulmonary aspiration group. Significantly(p=.000) more subjects(94.44%) in the pulmonary aspiration group received formula via a 50cc syringe than those in the non-pulmonary aspiration group(22.22%). CONCLUSION: Critically ill patients may need more time for head-elevation after tube feeding to prevent pulmonary aspiration. In practice, enteral formula should not be given the patients via a 50cc syringe anymore, instead a feeding bag or infusion pump should be used to prevent pulmonary aspiration.
Catheters ; Critical Illness ; Enteral Nutrition ; Feeding Methods* ; Glucose* ; Humans ; Infusion Pumps ; Suction ; Syringes ; Tracheostomy ; Surveys and Questionnaires

PURPOSE: Exclusive enteral nutrition (EEN) therapy effectively induces clinical remission in Crohn's disease (CD). It remains unclear, however, whether partial enteral nutrition (PEN) can maintain remission. This study was performed to determine the abilities of oral EEN and oral PEN to induce and maintain clinical remission in pediatric patients with CD, respectively. MATERIALS AND METHODS: Pediatric patients with CD who received oral EEN at a single center in 2000-2014 were identified retrospectively. Remission rates of the EEN and PEN during the 2 years study period were determined. Risk factors for EEN and PEN failure were identified. RESULTS: Of the 66 patients who started EEN, 61 (92%) completed the course. Clinical remission was achieved in 88% (58/66) of the patients. All 58 patients with remission continued with PEN: 43 (74%) were treatment adherent. The cumulative remission rates at 1 and 2 years were 67% and 52%, respectively. Differing from EEN, limited therapeutic efficacy of PEN was shown in severe CD patients. Female gender associated significantly with non-adherence. CONCLUSION: Oral EEN and PEN effectively induced and maintained remission in a pediatric population. Non-adherence was a limiting factor in the success of therapy.
Adolescent ; Child ; Crohn Disease/*therapy ; Enteral Nutrition/*methods ; Female ; Humans ; Male ; Remission Induction ; Retrospective Studies