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Enteral and Parenteral Nutrition

  • Manie Juneja
  • Stephen J. D. O’Keefe
Chapter

Abstract

Malnutrition is more common in geriatric population because of higher incidence of chronic disability and disease, but the principles of nutritional support are the same as those for any adult. Nutrition support should be implemented in a step-wise fashion, starting with dietary consultation with a nutritionist with recommendations for dietary change or supplementation. If this fails, nasogastric feeding should be considered. In the presence of anatomic changes in the upper gastrointestinal tract, a more distal postpyloric feeding tube should be considered. Intestinal failure is the only absolute indication for parenteral feeding, but initial PN supplementation may be necessary in the critically ill depleted patient while awaiting enteral feeding (EN). In the vast majority of patients, a simple low-cost polymeric formula will meet EN requirements. Extra care should be taken in the elderly terminal patient to avoid long-term “forced feeding,” whether it be EN, PN, or via gastrostomy, as these interventions are associated with poor outcomes and may actually impair the remaining quality of life.

Keywords

Parenteral Nutrition Enteral Nutrition Percutaneous Endoscopic Gastrostomy Enteral Feeding Thiamine Deficiency 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Internal MedicineGeorgetown University HospitalWashingtonUSA
  2. 2.Department of Gastroenterology, Hepatology and NutritionUniversity of Pittsburgh Medical CenterPittsburghUSA

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