Enteral or parenteral nutrition? Pro-enteral.
There is a convincing evidence for the superiority of enteral nutrition as compared with parenteral In critically ill and injured patients. The general objectives of providing nutritional support in the critically ill is to persevere body functions that are functioning normally and to facilitate recovery of those that are failing. The specific objective for enteral nutrition is, however, preservation and restoration of the gastrointestinal structure and function. Today, early enteral nutrition is an integral part of the acute management of critically ill patients. It is no longer a therapy which can be started "if" necessary just to prevent malnutrition. Early enteral nutrition can be successfully carried out in virtually all critically ill patients also after major abdominal surgery and in acute pancreatitis. There are very few contraindications for using enteral nutrition and severe complications are rare. Parenteral nutrition, on the other hand, is associated with increased incidence of infectious complications and is rarely indicated in critically ill patients.
Sigurdsson
G
G
Department of Anaesthesia and Intensive Care Medicine, University of Berne, Inselspital, Switzerland.
D000005:Abdomen / Q000601:surgery; D001424:Bacterial Infections; D000075202:Contraindications; D016638:Critical Illness; D004064:Digestive System / Q000033:anatomy & histology / Q000276:immunology / Q000382:microbiology; D004068:Digestive System Physiological Phenomena; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods; D006801:Humans; D015994:Incidence; D009748:Nutrition Disorders / Q000628:therapy; D010195:Pancreatitis / Q000628:therapy; D010288:Parenteral Nutrition / Q000009:adverse effects; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000628:therapy