Résumé
Le support nutritionnel entéral joue un rôle majeur dans la conduite du traitement des malades hospitalisés en état critique dans une unité de soins intensifs (USI); il s’agit de patients non motivés envers les apports alimentaires, de sujets souffrant de troubles neurologiques chroniques ou de dysphagie d’origine mécanique, et encore d’individus atteints de dysfonctionnement entéral. L’endoscopiste joue un rôle clé dans la prise en charge de ces affections. De nouvelles techniques et des équipements améliorés ont étendu les moyens d’accès entéral mis à la disposition de l’endoscopiste. De plus, des modifications de la pratique clinique, épaulées par des données récentes, relatives au bénéfice de l’alimentation entérale par rapport à la nutrition parentérale totale (NPT) ou aux méfaits d’une absence de support nutritionnel, montrent la nécessité d’un recours accru aux méthodes endoscopiques.
Le but du présent article est de dresser une revue de l’état de la question de l’alimentation entérale; de ses modifications rapides et son champ de développement. Cela couvre le type d’aliments, les voies d’accès, et les problèmes qui peuvent survenir au cours d’une alimentation entérale.
Summary
Enteral nutritional support has a major role in the management of critically ill patients in intensive care units (ICU), those with poor votitional intake, persons with chronic neurologic or mechanical dysphagia, and individuals with gut dysfunction. The endoscopist has a key role in the management of these conditions. Newer techniques and improved equipment have expanded the repertoire of enteral-access procedures available to the endoscopist. Additionally, changes in clinical practice, spurred by recent data demonstrating the benefit of enteral over total parenteral nutrition (TPN) or no nutritional support present a significant area of need for endoscopic procedures.
The purpose of the following article is to provide a review of the current state of enteral feeding, a rapidly changing and developing field. It covers the type of feed, the routes of access, and the problems that can occur with enteral feeding.
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Abbreviations
- TNE:
-
tube nasoentérique
- TNG:
-
tube nasogastrique
- GEP:
-
gastroscopie endoscopique per cutanée
- JEP:
-
jéjunostomie endoscopie per cutanée
- SRIS:
-
syndrome de la réponse inflammatoire systémique
- DMO:
-
déficience multiorganique
- NET:
-
nasoenteric tube
- NGT:
-
nasogastric tube
- PEG:
-
percutaneous endoscopic gastroscopy
- PEJ:
-
percutaneous endoscopic jejunostomy
- SIRS:
-
systemic inflammatory response syndrome
- MOF:
-
multi organ failure
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Stein, J., Hoepffner, N. Nutrition entérale par voie endoscopique. Indications et limites. Acta Endosc 32, 719–737 (2002). https://doi.org/10.1007/BF03028478
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DOI: https://doi.org/10.1007/BF03028478