Enteral and Parenteral Nutrition
is a topic covered in the Harrison's Manual of Medicine
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Nutritional support should be initiated in pts with malnutrition or in those at risk for malnutrition (e.g., conditions that preclude adequate oral feeding or pts in catabolic states, such as sepsis, burns, major surgery, or trauma). An approach for deciding when to use various types of specialized nutrition support (SNS) is summarized in Fig. 7-1.
Enteral therapy refers to feeding via the gut, using oral supplements or infusion of formulas via various feeding tubes (nasogastric, nasoduodenal, gastrostomy, jejunostomy, or combined gastrojejunostomy). Parenteral therapy refers to the infusion of nutrient solutions into the bloodstream via a peripherally inserted central catheter (PICC), a centrally inserted externalized catheter, or a centrally inserted tunneled catheter or subcutaneous port. When feasible, enteral nutrition is the preferred route because it sustains the digestive, absorptive, and immunologic functions of the GI tract, and because it minimizes the risk of fluid and electrolyte imbalance. Parenteral nutrition is often indicated in severe pancreatitis, necrotizing enterocolitis, prolonged ileus, and distal bowel obstruction.
Decision-making for the implementation of specialized nutrition support (SNS). CVC, central venous catheter; PCM, protein-calorie malnutrition; PICC, peripherally inserted central catheter. (Adapted from chapter in Harrison’s Principles of Internal Medicine, 16e, by Lyn Howard, MD.)
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Loscalzo, Joseph, et al., editors. "Enteral and Parenteral Nutrition." Harrison's Manual of Medicine, 19th ed., McGraw Hill Inc., 2017. harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623214/all/Enteral_and_Parenteral_Nutrition.
Enteral and Parenteral Nutrition. In: Loscalzo J, Jameson JL, Longo DL, et al, eds. Harrison's Manual of Medicine. 19th ed. McGraw Hill Inc.; 2017. https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623214/all/Enteral_and_Parenteral_Nutrition. Accessed April 23, 2019.
Enteral and Parenteral Nutrition. (2017). In Loscalzo, J., Jameson, J. L., Longo, D. L., Hauser, S. L., Fauci, A. S., & Kasper, D. L. (Eds.), Harrison's Manual of Medicine. Available from https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623214/all/Enteral_and_Parenteral_Nutrition
Enteral and Parenteral Nutrition [Internet]. In: Loscalzo J, Jameson JL, Longo DL, Hauser SL, Fauci AS, Kasper DL, editors. Harrison's Manual of Medicine. McGraw Hill Inc.; 2017. [cited 2019 April 23]. Available from: https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623214/all/Enteral_and_Parenteral_Nutrition.
TY - ELEC
T1 - Enteral and Parenteral Nutrition
ID - 623214
ED - Loscalzo,Joseph,
ED - Jameson,J Larry,
ED - Longo,Dan L,
ED - Hauser,Stephen L,
ED - Fauci,Anthony S,
ED - Kasper,Dennis L,
BT - Harrison's Manual of Medicine
UR - https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623214/all/Enteral_and_Parenteral_Nutrition
PB - McGraw Hill Inc.
ET - 19
DB - Harrison's Manual of Medicine
DP - Unbound Medicine