Nasogastric enteral feeding

Oral, nasogastric, gastrostomy, nasoduodenal, nasojejunal, or jejunostomy methods are used for enteral feedings. 

Mimoz O, Binter V, Jacolot A, Edouard A, Tod Nf Petitjean O, Samii K. Pharmacokinetics and absolute bioavailability of ciprofloxacin administered through a nasogastric tube with continuous enteral feeding to critically ill patients. Intensive Care Med (1998) 24, 1047-51. 

The absorption of phenytoin can be affected by some foods. A very marked reduction in phenytoin absorption has been described when it was given with enteral feeds (e.g. Isocal, OsmoUte), by nasogastric or jejunostomy tubes. 

A study in 20 patients and 5 healthy subjects found that phenytoin absorption was reduced by about 70% when it was given by nasogastric tube with an enteral feed product (Isocat) at a rate of 100 to 125 mL/hour. Other reports describe the same interaction in patients given Ensure Isocaiydi or Os/nofite. " ... 

However, another study in healthy subjects found the absolute bioavailability of phenytoin suspension or phenytoin sodium solution given by nasogastric tube was not affected by an enteral feed product (Isocat) ... 

Weinryb J, Cogen R. Interaction of nasogastric phenytoin and enteral feeding solution. JAm... 

Fleisher D, Sheth N, Kou JH. Phen3 oin interaction with enteral feedings administered through nasogastric tubes. J Parenter Enteral Nutr ( 990) 14, 513-16. 

A number of reports describe the development of hard putty-like or creamy precipitations and encrustations that have blocked the oesophagus or stomach of patients given sucralfate with enteral feeds (Ensure Pbis Fresubin plus F or Osmolit ). Another patient developed this precipitate when treated with Isocal and sucralfate with aluminium/magnesium hydroxide. Similarly, a patient receiving Pubnocare nasogastric feed, sucralfate and aluminium hydroxide gel also developed an oesophageal be-zoar, which was analysed and found to contain components of both the drugs and the enteral feed. ... 

Risk factors contributing to the development of PMC are age (>60 years) previous surgical intervention non-surgical gastrointestinal procedures presence of a nasogastric tube and enteral feeding antiulcer medication, hospitalisation in an intensive care unit malignancies (lymphoma, leukaemia) immunosuppression transplantation irradiation pulmonary disease severe cardiac disease and heavy-metal exposure (Ros et al. 1996 Cleary 1998 Dallal et al. 2002). 

A 63-year-old morbidly obese man with Parkinson s disease and type 2 diabetes mellitus was given enteral feeds after multiple trauma, and his medications (pramipexole, entacapone, and immediate-release levodopa+carbidopa) were given via nasogastric tube. When his enteral feeds were changed to a formula that provided... 

Singh N, Sharma B, Sharma M, Sachdev V, Bhardwaj P, Mani K, et al. Evaluation of early enteral feeding through nasogastric and nasojeju-nal tube in severe acute pancreatitis a noninferiority randomized controlled trial. Pancreas January 2012 41(l) 153-9. 

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