[Biological and clinical surveillance techniques: problems and complications of enteral feeding]

The present high degree of safety of enteral nutrition is due to improvements in commercial nutritional products and, chiefly, to the respect of well-established rules of administration. Monitoring the equipment consists of making sure, by means of repeated rinsing, that the fine digestive tract prosthesis remains patent. Nutrients are now sterile and easy to use, and their compositions varied and well-balanced. They are very well tolerated in most cases. Monitoring the speed of gastrointestinal (GI) transit is crucial. One must watch for the occurrence of multiple daily stools, due to the speed of administration or to malabsorption, proliferation of exogenous or endogenous pathogens or patient's underlying pathology, and for a gastric fluid residual volume exceeding 150 ml. Regular controls of gastric emptying and of GI prosthesis position prevent the very rare complications that are aspiration pneumonia and unexplained chronic dyspnoea. Possible interference between enteral nutrition and patient's pathology or treatment must be detected and prevented.