title: Experience of post-pyloric feeding in seriously ill patients in clinical practice.
abstract: BACKGROUND
  Maintaining nutrition is an integral part of patient care and when it is possible enteral nutrition is regarded as superior to parenteral nutrition. Post-pyloric feeding may enable enteral feeding to be maintained in patients who cannot tolerate nasogastric feeding. The success of post-pyloric feeding in routine clinical practice is uncertain.
  
  
  METHODS
  One hundred and forty six consecutive patients who had 150 separate episodes of post-pyloric feeding were identified. Casenotes were reviewed to assess indication for post-pyloric feeding, prior use of alternative methods of feeding, success of achieving nutritional requirements and patient outcome.
  
  
  RESULTS
  A post-pyloric tube was successfully placed in 138 (92%) and nutritional requirements were met by post-pyloric feeding alone in 124 (83%). Post-pyloric feeding was used for between 2 and 254 days (median 14 days). Conditions for which post-pyloric feeding was used to administer nutritional support included burn injury, pancreatitis, sepsis, post-operative gastric stasis, bone marrow transplantation and chemotherapy induced vomiting. Fifty (33%) patients had an attempt at nasogastric feeding and 33 (22%) were on total parenteral nutrition before post-pyloric feeding was commenced. There was one major complication of a jejunal ulcer bleed in the series. Minor complications included displacement of the nasojejunal tube and failure to absorb feed related to gastrointestinal dysfunction.
  
  
  CONCLUSIONS
  Post-pyloric feeding can be successfully used to maintain enteral nutrition in patients who would otherwise require parenteral nutrition.
authors.affiliation: Department of Gastroenterology, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PD, UK. robandakathome@hotmail.com
authors.forename: J R
authors.initials: JR
authors.lastname: Boulton-Jones
authors.forename: J
authors.initials: J
authors.lastname: Lewis
authors.forename: J C
authors.initials: JC
authors.lastname: Jobling
authors.forename: K
authors.initials: K
authors.lastname: Teahon
mesh_terms: D016638:Critical Illness / Q000628:therapy*; D004386:Duodenum; D004750:Enteral Nutrition / Q000379:methods; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000379:methods*; D007583:Jejunum; D008297:Male; D009751:Nutritional Requirements; D012189:Retrospective Studies; D016896:Treatment Outcome