Advantages of enteral nutrition over parenteral nutrition

Abstract

It is a strong and commonly held belief among nutrition clinicians that enteral nutrition is preferable to parenteral nutrition. We provide a narrative review of more recent studies and technical reviews comparing enteral nutrition with parenteral nutrition. Despite significant weaknesses in the existing data, current literature continues to support the use of enteral nutrition in patients requiring nutrition support, over parenteral nutrition.

Our experience of enteral and parenteral nutrition support assessment in Turkey

“…ENS is known to shorten length of stay in ICU, decreases infection rate and diminishes mechanical ventilation time especially within the first 48 hours following trauma and surgical intervention. 4 In our results, increase of the enteral nutrition in ICU patients was found to be parallel to the increase of ENS over years.…”

“…14 Enteral nutrition is more physiologic with less complications than parenteral nutrition. It is believed to prevent mucosal atrophy and endotoxin translocation, thus protecting barier function 4,6 Due to this advantage it provided to our patients, number of ENS increased in the last four and a half years.…”

“…Total daily energy or protein energy deficiency cause infective complications and increase of the number of days on mechanical ventilation and hospitalization. 1,3,4 Retardation is observed in growth, learning and cognitive functions as a result of non-optimal nutrition. 1 Nutrition support should be started in an early period in patients with malnutrition whom oral intake is impaired in a period longer than 5-7 days or expected to be impaired.…”

Nutritional and health benefits of semi-elemental diets: A comprehensive summary of the literature

“…Relevant results 1 Polk et al [11] Children, tanner stage I-II, mean age 13 Height increased 2.6 ± 0.8 to 9.3 ± 0.9 cm/yr (P < 0.0001) Weight increased 3.0 ± 1.2 to 6.63 ± 1.2 kg/yr (P < 0.02) Somatomedin C increase 0.7 ± 0.1 to 1.8 ± 0.3 UL (P < 0.0001) Albumin increase 3.4 ± 0.2 to 4.0 ± 0.1 g/dL (P < 0.0003) CDAI increase 64 ± 3.4 to 80.1 ± 2.2 (P < 0.01) (disease activity inversely correlates with numerical score) Hussey et al [13] Children with active CD, mean age 11. 10 -single group 6 wk Height increased 143.8 ± 13 to 144.5 ± 13.1 cm (P < 0.01) Weight increases 31.9 ± 7.2 to 36.5 ± 8.1 kg (P < 0.0001) PCDAI decrease 40 ± 13 to 5 ± 6 (P < 0.0001) (lower score corresponds to lower disease activity) Albumin increase 3.1 ± 0.4 to 3.8 ± 0.4 g/dL (P < 0.01) PEDIBDQ increase 198 ± 31 to 243 ± 34 (P < 0.01) (higher score indicating better quality of life) Royall et al [14] Adults with moderate to severely active CD RCT Peptamen administered via a nasoduodenal feeding tube (Vivonex-TEN, amino acid based formula) 21 (19) 3 wk Remission rates after 3 wk: 75% in the peptide group, 84% in the amino acid group Remission rates after 1 yr: 40% in the peptide group, 31% in the amino acid group Weight increased 2.0 ± 0.5 kg in the peptide group and 1.7 ± 0.3 kg in the amino acid group (P < 0.0005 within group differences after 3 wk) Total phospholipids (mg/mL) concentration increase in the peptide group (1.37 ± 0.1 to 1.71 ± 0.15) (P < 0.025) (no difference in amino acid group) Mansfield et al [15] Adults with active CD RCT Pepti-2000 LF Liquid received through nasogastric tube (Elemental 028)…”

“…In these nutritionally-vulnerable populations, additional nutritional support via parenteral nutrition (PN) or enteral nutrition (EN) is necessary. When feasible, EN is clearly favored over PN because of fewer infectious complications, reduced healthcare costs, improved return of gut function, and reduced length of hospital stay [1] . Elemental diet formulas are used to provide liquid nutrients in a form that is easily and readily assimilated.…”