Prevalence, Outcomes, and Management of Enteral Tube Feeding Intolerance: A Retrospective Cohort Study in a Tertiary Center

Wang, Kailun; McIlroy, Kerry; Plank, Lindsay D.; Petrov, Maxim S.; Windsor, John A.

doi:10.1177/0148607115627142

Cited by 56 publications

(91 citation statements)

References 27 publications

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“…Monitoring for EN intolerance often includes multiple parameters such as GRV and assessment of GI function 6 . In a recent observational study, Wang and colleagues 7 reported that 32% of patients receiving EN in a large tertiary hospital experienced enteral feeding intolerance. Of those patients, approximately two‐thirds demonstrated a single high GRV, whereas one‐third experienced a combination or 2 or more of the following symptoms: high GRV, nausea/vomiting, and abdominal distention.…”

Section: Section 10 Monitoring and Reassessmentmentioning

confidence: 99%

ASPEN Safe Practices for Enteral Nutrition Therapy

Boullata

Carrera²,

Harvey

et al. 2016

J Parenter Enteral Nutr

351

531

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Enteral nutrition (EN) is a valuable clinical intervention for patients of all ages in a variety of care settings. Along with its many outcome benefits come the potential for adverse effects. These safety issues are the result of clinical complications and of process-related errors. The latter can occur at any step from patient assessment, prescribing, and order review, to product selection, labeling, and administration. To maximize the benefits of EN while minimizing adverse events requires that a systematic approach of care be in place. This includes open communication, standardization, and incorporation of best practices into the EN process. This document provides recommendations based on the available evidence and expert consensus for safe practices, across each step of the process, for all those involved in caring for patients receiving EN.

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Section: Section 10 Monitoring and Reassessmentmentioning

confidence: 99%

ASPEN Safe Practices for Enteral Nutrition Therapy

Boullata

Carrera²,

Harvey

et al. 2016

J Parenter Enteral Nutr

351

531

View full text Add to dashboard Cite

show abstract

“…Furthermore, Wang et al recently showed that delayed gastric emptying or gastroparesis, as measured by increased gastric residual volume, was the most frequently observed ETFI (63%) in hospitalized patients (n = 754), followed by nausea and vomiting (36%). Delayed food delivery to the small intestine has the potential to compromise the rate and magnitude of absorption in critically ill patients and, likely, all clinical populations.…”

Section: Methodsmentioning

confidence: 99%

“…However, ginger has most notably been studied for its ability to combat morning sickness, postoperative nausea and vomiting, and chemotherapy‐induced nausea and vomiting . A retrospective cohort study involving chart review of 754 hospitalized patients by Wang et al estimated that 36% of hospitalized patients receiving TFs experience nausea and vomiting. Similarly, a multicenter, prospective study of 298 hospitalized adults by Bloechl‐Daum and colleagues reported clinically relevant symptoms in up to 60% of patients undergoing chemotherapy, many of whom required TF support.…”

Section: Methodsmentioning

confidence: 99%

“…It is estimated that a half‐million people in the United States are reliant on TFs and approximately 10% of hospitalized patients require some form of nutrition support . With the increasing aging population and reported benefits of enteral feeds, this number is expected to rise over the next 5 years .…”

Section: Introductionmentioning

confidence: 99%

“…Identifying, preventing, and treating malnutrition is a priority quality improvement initiative among hospitals . However, despite the clinical and economic consequences of malnutrition resulting from ETFI, effective treatment strategies remain elusive …”

Section: Introductionmentioning

confidence: 99%

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Natural Bioactive Food Components for Improving Enteral Tube Feeding Tolerance in Adult Patient Populations

2017

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Tube feeding (TF) is the most common form of nutrition support. In recent years, TF administration has increased among patient populations within and outside hospital settings, in part due to greater insurance coverage, reduced use of parenteral nutrition, and improved formularies suitable for sole source nutrition. With increasing life expectancy and improved access to TFs, the number of adults dependent on enteral nutrition is expected to grow. However, enteral TF intolerance (ETFI) is the most common complication of TFs, typically presenting with at least 1 adverse gastrointestinal event, including nausea, diarrhea, and constipation. ETFI often leads to reductions in TF volume with associated energy and protein deficits. Potentially ensuing malnutrition is a major public health concern due its effects on increased risk of morbidity and mortality, infections, prolonged hospital length of stay, and higher healthcare costs. As such, there is a need for intervention strategies to prevent and reduce ETFI. Incorporating whole foods with bioactive properties is a promising strategy. Emerging research has elucidated bioactive properties of whole foods with specific benefits for the prevention and management of adverse gastrointestinal events commonly associated with TFs. However, lack of evidence-based recommendations and technological challenges have limited the use of such foods in commercial TF formulas. This review addresses research gaps by discussing 5 whole foods (rhubarb, banana, curcumin, peppermint oil, and ginger) with bioactive attributes identified through literature searches and clinical experience as having substantial scientific rationale to consider their application for ETFI in adult populations. (Nutr Clin Pract. 2018;33:107-120) Keywords enteral nutrition; enteral formulas; tube feeding; dietary supplements; digestive signs and symptoms SummaryTube feeding (TF) is the most common form of nutrition support. In recent years, TF administration has increased among patient populations within and outside hospital settings, in part due to greater insurance coverage, reduced use of parenteral nutrition (PN), and improved formularies suitable for sole source nutrition. With increasing life expectancy and improved access to TFs, the number of adults dependent on enteral nutrition (EN) is expected to grow. However, enteral TF intolerance (ETFI) is the most common complication of TFs, typically presenting with at least 1 adverse gastrointestinal (GI) event, including nausea, diarrhea, and constipation. ETFI often leads to reductions in TF volume with associated energy and protein deficits. Potentially ensuing malnutrition is a major public health concern due its effects on increased risk of morbidity and mortality, infections, prolonged hospital length of stay, and higher healthcare costs. As such, there is a need for intervention strategies to prevent and reduce ETFI. Incorporating whole foods with bioactive properties is a promising strategy. Emerging research has elucidated bioactive properties ...

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