Enteral access in adults

Enteral feeding in neurological disorders

“…It is usually reserved for patients in whom gastric feeding is contraindicated, for example, due to severe gastro-oesophageal reflux disease, gastroparesis, altered anatomy, gastric outlet syndrome, gastric fistula or those at high risk of aspiration pneumonia 11 15 16. A Cochrane review comparing gastric versus post-pyloric tube feeding suggested that post-pyloric tube feeding delivered more nutrients and lower risk of pneumonia in severely ill patients; however, currently we still have only limited evidence 17…”

“…Total parenteral nutrition can be used either for short or prolonged periods, and is indicated for patients with chronic gastrointestinal tract dysfunction or whose gastrointestinal tract is not accessible 16 30. Long-term home parenteral nutrition is usually delivered via a tunnelled central venous catheter or, alternatively, through an implantable port 31.…”

Self-Expandable Metallic Stent Placement for the Palliation of Esophageal Cancer

“…The following reasons have been suggested in an attempt to explain the negative outcomes associated with SEMS placement as a bridge therapy: First, mechanical injury caused by SEMS results in fibrosis that compromises the resectability of the tumor; Second, SEMS placement increases the levels of circulating neoplastic cells; Third chemotherapy increases the incidence of SEMS-related complications, such as migration and ERF; and Fourth, accurate restaging of the tumor after SEMS placement is technically difficult (454647). Therefore, some investigators argue that the placement of a feeding tube or percutaneous gastrostomy may be preferable over SEMS placement as a bridging therapy (4849). It should be noted, however, that in the study of Mariette et al (43), SEMS was not removed until just before surgery; this factor may be the main reason for the negative outcomes.…”

“…Complications of SEMS placement can also be classified as major and minor. Major complications are life-threatening conditions such as ERF, bleeding, and perforation; minor complications are those that are not life-threatening, including migration, tumor ingrowth and overgrowth, and food impaction (3212223242526272829303132333435363738394041424344454647484950515253545556575859606162636465666768). …”

Methods to determine the internal length of nasogastric feeding tubes: An integrative review

“…Despite the benefits and widespread use of tube feeding, some patients may experience complications either due to the enteral access itself or to the enteral feeding (Toussaint et al, 2015). If the tube migrates from the stomach into the esophagus or lung, there can be serious consequences, such as esophageal perforation (Isik et al, 2014), esophageal stenosis (Ribeiro et al, 2011), pneumothorax (Lyske, 2011); (Agha and Siddiqui, 2011), aspiration pneumonia (Xu and Li, 2011) and bronchopulmonary complications (Schreiber et al, 2014).…”