[Enteral nutrition: techniques and indications]

Abstract

Enteral nutrition must be preferred to parenteral nutrition if case of intact digestive tract. Naso-gastric tubes are frequently used, particularly in enteral feeding. However, the use of naso-enteral tubes, i.e. naso-duodenal and naso-jejunal tubes, is expected to increase in the future. Their efficacy has been demonstrated in two specific cases: intensive care (post-operative or post-traumatic states), acute pancreatitis. A third potential use is in the replacement of a naso-gastric tube by a naso-jejunal tube in cases of frequent aspiration pneumonia related to a gastro-esophageal reflux. Gastro- and jejunostomies have to be indicated when enteral nutrition is thought to be used for more than one month. The insertion of a naso-gastric tube is generally performed by the nurse following medical guidelines and the insertion of a naso-jejunal tube is often done during an endoscopy by the physician. The verification of the correct position of the tube should preferably be done with an X-ray confirmation. However, this is difficult to perform at home and the most frequent method for control is the clinical method by auscultation. Enteral nutrients are generally polymeric and infused with gravity without a peristatic pump excepted in children. In conclusion, technical improvements in enteral nutrition have led to a simple, cost-effective and low risk methods of treatment.