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1Department of Medicine, University of Toronto, Division of Gastroenterology, St. Michael's Hospital, Toronto, Ontario, Canada. khushjeejeebhoy@compuserve.com
Current Opinion in Gastroenterology
|October 13, 2006
Summary
Enteral nutrition is now preferred over parenteral nutrition for hospital patients, but its optimal timing and use of immune-enhancing nutrients remain debated. Potential risks include pneumonia and bowel ischemia, while benefits for Crohn disease and long-term care patients require further study.
Area of Science:
- Clinical Nutrition
- Gastroenterology
- Critical Care Medicine
Background:
- Malnutrition significantly increases morbidity and mortality in hospitalized patients.
- Parenteral nutrition was favored in the 1970s, but enteral nutrition is now the preferred method.
- The evolution of nutritional support strategies in hospitals over 50 years.
Purpose of the Study:
- To review the current evidence and controversies surrounding enteral nutrition in hospital patients.
- To discuss the optimal timing and composition of enteral nutrition.
- To evaluate the risks and benefits of enteral nutrition compared to parenteral nutrition.
Main Methods:
- Review of scientific literature on nutritional support in hospitals.
- Analysis of the historical shift from parenteral to enteral nutrition.
- Discussion of debated topics including timing, immune-enhancing nutrients, and complications.
Main Results:
- Enteral nutrition has largely replaced parenteral nutrition.
- Debates persist regarding early initiation (within 24 hours) and the use of immune-enhancing nutrients.
- Potential complications include aspiration pneumonia and bowel ischemia; benefits for Crohn disease and long-term care patients are under investigation.
Conclusions:
- Enteral nutrition is the preferred route for nutritional support in hospitals.
- Further research is needed to clarify optimal protocols, especially concerning timing and specific patient populations.
- The long-term impact of enteral nutrition on quality of life in demented or vegetative patients remains unclear.
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