Enteral feeding is more favorable than parenteral one because it can significantly intervene against the colonization of bacteria and preserve gut functions. However, this necessitates the presence of a good-functioning gastrointestinal tract. Young infants, critically ill children, and patients with neurological disabilities are the most probable candidates to perform enteral feeding. In the present literature review, we have discussed the indications and long-term results of enteral feeding in pediatric settings. Our results show that modality is a safe and efficacious modality in these settings with favorable outcomes and fewer adverse events and complications. Many indications were reported for the modality, and in general, children that usually suffer from severe weight deficit, weight faltering, and growth retardation are indicated to receive enteral nutrition. Some contraindications were also reported in the literature, and in general, conditions affecting the function and health status gastrointestinal tract should recommend against conducting approaches of enteral feeding. Different complications were reported, including mechanical, metabolic, infectious, gastrointestinal, and drug-related complications that might lead to worsened prognosis and can significantly impact the long-term outcomes of these patients. Therefore, paying adequate attention should be considered in these cases to prevent the development of these complications, and provide all the necessary procedures to potentially manage the expected adverse events.
The coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and predominantly manifests with respiratory symptoms. However, it may have a wide range of complications, including hematological complications. Several studies demonstrated that patients with COVID-19 exhibit a wide range of complex abnormalities of the coagulation system. We report the case of a 22-year-old man who presented to our emergency department with a cough and fever for one week. His vital signs were normal. Since the patient was young and mildly symptomatic, he was offered the option of home isolation for seven days. Two weeks later, the patient presented to the emergency department complaining of sudden shortness of breath that was associated with chest pain. The oxygen saturation was 92% on room air. The patient underwent computed tomography pulmonary angiography. The scan showed a centric filling defect in the main right and left pulmonary arteries representing pulmonary embolism. Further, the scan showed a thrombus in the inferior vena cava that was the source of bilateral pulmonary embolism. The patient was admitted to the intensive care unit. He received full anticoagulation with heparin. After recovery, he underwent a thrombophilia screen, which yielded normal findings. The present case demonstrated that thromboembolic events may develop even after the recovery from mild COVID-19 pneumonia. In the appropriate clinical settings, physicians should maintain a high index of suspicion of coagulopathy in any patient with recent COVID-19 pneumonia. Further studies are needed to determine the indication and duration of the thromboprophylaxis following the recovery from COVID-19.
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