title: Gastroenteric tube feeding: techniques, problems and solutions.
abstract: Gastroenteric tube feeding plays a major role in the management of patients with poor voluntary intake, chronic neurological or mechanical dysphagia or gut dysfunction, and patients who are critically ill. However, despite the benefits and widespread use of enteral tube feeding, some patients experience complications. This review aims to discuss and compare current knowledge regarding the clinical application of enteral tube feeding, together with associated complications and special aspects. We conducted an extensive literature search on PubMed, Embase and Medline using index terms relating to enteral access, enteral feeding/nutrition, tube feeding, percutaneous endoscopic gastrostomy/jejunostomy, endoscopic nasoenteric tube, nasogastric tube, and refeeding syndrome. The literature showed common routes of enteral access to include nasoenteral tube, gastrostomy and jejunostomy, while complications fall into four major categories: mechanical, e.g., tube blockage or removal; gastrointestinal, e.g., diarrhea; infectious e.g., aspiration pneumonia, tube site infection; and metabolic, e.g., refeeding syndrome, hyperglycemia. Although the type and frequency of complications arising from tube feeding vary considerably according to the chosen access route, gastrointestinal complications are without doubt the most common. Complications associated with enteral tube feeding can be reduced by careful observance of guidelines, including those related to food composition, administration rate, portion size, food temperature and patient supervision.
authors.affiliation: Irina Blumenstein, Department of Gastroenterology and Clinical Nutrition, Johann Wolfgang Goethe University Clinic, 60590 Frankfurt, Germany.
authors.forename: Irina
authors.initials: I
authors.lastname: Blumenstein
authors.affiliation: Irina Blumenstein, Department of Gastroenterology and Clinical Nutrition, Johann Wolfgang Goethe University Clinic, 60590 Frankfurt, Germany.
authors.forename: Yogesh M
authors.initials: YM
authors.lastname: Shastri
authors.affiliation: Irina Blumenstein, Department of Gastroenterology and Clinical Nutrition, Johann Wolfgang Goethe University Clinic, 60590 Frankfurt, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Stein
mesh_terms: D003299:Cooperative Behavior; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D005767:Gastrointestinal Diseases / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008171:Lung Diseases / Q000209:etiology / Q000517:prevention & control; D008659:Metabolic Diseases / Q000209:etiology / Q000517:prevention & control; D009752:Nutritional Status; D010348:Patient Care Team; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Buried bumper syndrome; Colocutaneous fistulae; Enteral nutrition; Enteral tube feeding; Nasoenteral tubes; Percutaneous endoscopic gastrostomy; Refeeding syndrome