Enteral nutrition continuous feeding

Enteral nutrition may be administered by continuous, cyclic, bolus, or intermittent methods and may be accomplished by bolus, gravity, or infusion pump-controlled techniques. The method of delivery depends on the location of the tip of the feeding tube, the clinical condition and intestinal function of the patient, the environment in which the patient resides, and the patient s tolerance to the tube feeding. 

Ms. O Rexia s BMI showed that she was close to death through starvation. She was therefore hospitalized and placed on enteral nutrition (nutrients provided through tube feeding). The general therapeutic plan, outlined in Chapter 1, of nutritional restitution and identification and treatment of those emotional factors leading to the patient s anorectic behavior was continued. She was coaxed into eating small amounts of food while hospitalized. 

Levothyroxine Concurrent continuous enteral nutrition reduced the absorption of levothyroxine in 13 adults with hypothyroidism, who were given levothyroxine via the feeding tube at their usual dose [46 ]. Two developed subcfinical hj othy-roidism and six developed overt hj othy-roidism within 2-3 weeks five remained euthyroid. 

A number of methods to minimize the interaction between phenytoin and continuous enteral feeding have been suggested, but no consensus exists. Some clinicians choose holding the feeding for 1 to 2 hours before and after phenytoin administration to minimize the interaction. But since this has not been proven effective and may result in suboptimal nutrition, others choose not to interrupt the feeding. 

Phosphorus can be omitted from the nutritional formula of patients receiving PN until the phosphorus level approaches normal (<5 mg/dL). It is prudent to monitor phosphorus concentrations daily and to add phosphorus in small doses once the serum concentration is below 4 mg/dL. Failure to do so can lead to severe hypophosphatemia (see Chap. 49) despite continued renal failure, especially in the patient treated with CRRT. Patients with persistently high serum phosphorus concentrations who have a functional gastrointestinal tract (GIT) can be prescribed phosphate-binding therapy (see Chap. 44) and enteral feedings low in phosphorus to minimize the absorption of exogenous phosphorus. 

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