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Access routes for nutritional therapy.

D L Waitzberg1, C Plopper, R M Terra

  • 1Department of Gastroenterology, University of São Paulo Medical School, Brazil. d.waitzberg@zaz.com.br

World Journal of Surgery
|February 24, 2001
PubMed
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Choosing the right access route for nutritional support, like enteral nutrition (EN) or total parenteral nutrition (TPN), is crucial for surgical patients. This review details preferred methods based on therapy duration and patient factors.

Area of Science:

  • Medical Nutrition Therapy
  • Surgical Patient Care
  • Gastroenterology

Background:

  • Enteral nutrition (EN) and total parenteral nutrition (TPN) are vital for surgical patients.
  • Nutritional therapy requires specific access routes determined by duration and patient condition.

Purpose of the Study:

  • To review and compare various access routes for EN and TPN in surgical patients.
  • To guide the selection of optimal nutrient delivery methods based on clinical scenarios.

Main Methods:

  • Review of literature on enteral and parenteral access routes.
  • Analysis of factors influencing route selection, including duration, patient risk, and procedure type.

Main Results:

  • Enteral feeding is preferred; nasoenteric tubes for <6 weeks, enterostomy for longer. Percutaneous endoscopic gastrostomy is preferred for non-laparotomy patients.

Related Experiment Videos

  • Peripheral intravenous access is limited to <10 days due to phlebitis risk.
  • Central venous catheters (CVCs) offer various options (nontunneled, tunneled, ports) for TPN, with implantable ports showing lower septic complication rates.

    • Conclusions:

    • Route selection for nutritional support must align with therapy duration and patient-specific risks, prioritizing enteral access when feasible.
    • Different types of central venous access devices have distinct indications and complication profiles.
    • Optimizing access for nutritional delivery is key to successful surgical patient management.