[Origin, functions and expectations of the specialty in nutritional support]

Considerations are presented on the causes and frequency at the beginning or worsening of malnutrition in hospitalized patients. Most of the children had a more accelerated metabolism, and we examined how this malnutrition modifies their metabolic and functional responses and increases morbidity and mortality. During the 20th century the study and treatment with total parenteral nutrition (TPN) began. This allows the patient's nourishment to be maintained through the administration of nutrients directly into the circulatory system because of the inability of the patient to receive food by the digestive route. The benefits, as well as the risks and complications of the procedure, have been documented for the last 30 years. On the other hand, the technology has allowed the modification of the physicochemical characteristics of the nutrients. This is an alternative for some of the digestive processes to favor its absorption in the intestine in those patients who cannot receive natural nourishment. This procedure is known as specialized enteral nutrition (SEN). These two groups of procedures (TPN and SEN) are the cornerstones of a new specialty. The meanings of this specialty are several, including nutritional support and metabolic support. The adoption of the term "endonutrition" is proposed.