When should enteral feedings be discontinued?

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From the Research

Discontinuation of Enteral Feedings

Enteral feedings should be discontinued in certain situations, including:

  • Gastrointestinal complications that do not resolve with appropriate management, such as vomiting and bowel movement disorders 1
  • Prolonged diarrhea that causes deficiency in nutrient absorption, malnutrition, and increase in mortality 1
  • Other causes of diarrhea that are not related to enteral feedings, after ruling out other causes of diarrhea 1

Measures to Prevent Gastrointestinal Complications

To avoid gastrointestinal complications, the following measures can be taken:

  • Start enteral nutrition as soon as possible with a small amount and gradually increase 1
  • Elevate the head of the bed (30° to 45°) to decrease the risk of reflux and aspiration 1
  • Switch to continuous administration or administration of prokinetic drugs or narcotic antagonists to promote gastrointestinal motility 1
  • Switch to jejunal access (postpyloric route) to decrease the risk of reflux and aspiration 1

General Guidelines for Enteral Feedings

General guidelines for enteral feedings include:

  • Enteral feedings should be continued as long as possible without interruption and discontinuation of enteral feedings should be done easily by appropriate measures, even if gastrointestinal complications occur 1
  • Enteral nutrition should be initiated upon admission to the ICU in the absence of contraindications 2
  • Gastric residual volumes to assess feeding tolerance should no longer be routinely measured 2
  • Enteral nutrition can be safely continued in most patients with secure airways undergoing anesthesia and resumed within 24 h of abdominal surgery 2

References

Research

Enteral tolerance in critically ill patients.

Journal of intensive care, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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