There are different situations in life when an adult cannot eat food in the usual way. This happens mainly after surgery. During the recovery period, a person is not able to chew and rise to digest food. But also at this time, the patient needs a constant supply of nutrients into the body for the functioning of all organs and the restoration of life. In this case, such a type of food intake into the body as enteral nutrition is used.
Enteral nutrition - what is it?
This is a type of patient therapy, its peculiarity is that the food enters through a probe or a special system. Most often, with this type of nutrition , special mixtures are used. They differ from ordinary food for an adult, since in certain conditions the patient can not take other foods.
The benefits of such nutrition
This type of nutrition has its advantages for patients:
- Physiological - nutrition passes directly to the digestive system, which allows it to be easily absorbed and give strength to the patient after surgery.
- Cheap food - to use this method does not need too much cost.
- It’s easy to use additional funds - there is no requirement for increased sterility, since it is quite simple to process the probe for enteral nutrition or the system for oral feeding with mixtures.
- It does not cause serious complications - the probe is inserted without any problems, therefore, there is no likelihood of development and occurrence of complications that are life-threatening for the patient.
- It allows you to provide the body with all the necessary substances, this is due to the selection of optimal mixtures for humans.
- Helps prevent the occurrence of atrophic phenomena in the digestive tract.
Indications for Enteral Nutrition
The development of medicine in the last two centuries has made it possible to determine what will be better for a person after surgery, methods that will help him recover faster and get the necessary strength with the least risk. So food mixtures after surgery with the help of additional medical devices has its advantages and indications. There are certain indications specifically for the mixtures that a person needs, as well as for the method of eating. Artificial nutrition is prescribed if:
- By virtue of his condition, the patient cannot eat when he is unconscious or cannot swallow.
- The patient should not eat food - this is a condition of acute pancreatitis or bleeding in the gastrointestinal tract.
- A sick person refuses food, then forced enteral nutrition is used. What is it when this condition occurs? This happens with anorexia nervosa, in which you can not immediately load the stomach with ordinary food, as there is a danger of death after a prolonged lack of nutrition. Also, for various infections, the patient may refuse to eat, in this case, an enteral nutrition system is used to fill the body with the necessary nutrients to fight this infection.
- Food does not meet the needs, this happens with injuries, catabolism, burns.
This type of nutrition is also prescribed for the following pathological conditions of the body:
- lack of protein and energy in the body, if it is not possible to ensure the supply of these substances in a natural way;
- with the occurrence of various neoplasms in the head, stomach and neck;
- if there are progressive diseases of the central nervous system, for example, Parkinson's disease, cerebrovascular stroke, various states of lack of consciousness;
- in oncological conditions after radiation and chemotherapy;
- often such nutrition is prescribed for severe gastrointestinal diseases: pancreatitis, pathological processes in the liver and biliary tract, malabsorption syndromes and short bowel, as well as Crohn’s disease;
- immediately after surgery in the body;
- with burns and acute poisoning;
- with the appearance of fistulas, sepsis;
- if complex infectious diseases develop;
- with severe depression;
- with varying degrees of human radiation damage.
Methods of introducing nutritional mixtures
Enteral nutrition of patients varies in the way they eat:
- Using a probe to inject the mixture into the stomach.
- The method of nutrition "sipping" is the ingestion of special food orally in small sips.
These methods are also called passive and active. The first is enteral probe nutrition, the infusion occurs using a special system and dispenser. The second is active, manual, carried out mainly with a syringe. To use this method, you need to dial a certain amount of the mixture and carefully inject it into the oral cavity of a sick person. Today, the advantage is given to infusor pumps, which automatically supply the mixture.
Enteral Nutrition Probes
Many relatives of patients ask: enteral nutrition - what is it and what means are needed for this? Indeed, for this method of filling the body with food, different probes are needed. They are divided into:
- nasogastric (nasoenteric) - thin plastic probes that have openings at a certain level, as well as weighting agents for ease of administration;
- percutaneous - are introduced after surgery (pharyngoscopy, gastrostomy, esophagostomy, jejunostomy).
Body Nutrition Modes
Understanding this issue, enteral nutrition - what it is, is not enough for its implementation. There are many nuances of introducing food into the body in this way, for example, the feed rate of the mixture. There are several modes of patient nutrition.
- Constant flow rate. Through the probe, the patient receives food at a certain speed, it is 40-60 ml / h. Then the specialist looks at the reaction of the patient. If the mixture is well tolerated, the speed can be gradually increased. On average, it increases by 25 ml / h for 8-12 hours, then during the same time you can add as much until the required speed is reached. If the operation has just passed and the patient is in serious condition, the mixture should be injected no more than 20-30 ml / h. It is necessary to carefully monitor the human condition. With nausea, diarrhea, convulsions or vomiting, either the rate of administration of the mixture or its concentration decreases. At the same time, one indicator changes so that there is no stress for the body.
- Artificial nutrition can be introduced cyclically. Such a cyclical diet consists in the fact that after continuous feeding the patient gradually reduces it at night, reducing it to a break for the night. This method is convenient for the patient and can be done through a gastrostomy.
- Session nutrition (periodic) is not for everyone. It is indicated for those patients who have diarrhea or gastrointestinal surgery. Such food is called periodic, as it is carried out in periods of 4-6 hours.
- Bolus nutrition. This mode is similar to a normal meal. The mixture is injected with a syringe or through a probe, but the rules of entry are strictly followed. Moreover, the speed does not exceed 240 ml per half hour. The number of meals per day 3-5 times. But starting the mixture is worth a hundred ml. If the patient tolerates without problems, then 50 ml is gradually added. But this regimen is dangerous with frequent occurrences of diarrhea, so it should be prescribed and occur under the supervision of a specialist.
Naturally, it is impossible to adjust these modes for all patients who need enteral nutrition. The selection of the method, speed and volume of such a supply of food to the body takes into account individual characteristics.
Features of the choice of mixtures
Mixtures for enteral nutrition should also be selected taking into account the individual needs of patients. Their choice depends on several factors.
- Good nutrition for postoperative patients should have good energy density. It is not less than 1 kcal / ml.
- The mixture should be free of lactose and glutein. These substances can cause allergies.
- It should have an osmolarity of not more than 340 mosm / l.
- To avoid problems with digestion, it should be inviscid.
- A quality mixture does not cause excessive intestinal motility.
- It is necessary that it contains information about the manufacturer and the presence of genetic modification of proteins.
It should be noted that the mixture for children, as well as solutions prepared from natural products, are not suitable for enteral nutrition. They are not balanced for an adult, so they can not bring the desired result. For patients in need of such nutrition, their own types of mixtures have been developed, which we will consider below.
Monomer mixtures
The name of the mixtures determines their purpose. They do not contain all the necessary set of trace elements, but are also used in the postoperative period. Such mixtures consist of glucose and salts, which allows to restore the functionality of the small intestine immediately after surgery. In the presence of vomiting or diarrhea, such nutrition well supports the water-electrolyte balance in the human body. Such mixtures include "Gastrolit", "Methusol", "Regidron", "Citroglucosolan", "Orasan" and some others.
Elemental Mixtures for Nutrition
This patient power supply is based on precisely selected chemical elements. They are used in specific cases of metabolic disorders in the body with pathologies such as liver and kidney failure, diabetes mellitus and pancreatitis. In this case, the pancreas, liver and kidneys cannot perform their specific functions, so such mixtures help a person at least partially restore life. This type of nutrition includes Vivonex, Flexical, Lofenalak and others.
Semi-element mixtures
These nutrient mixtures for patients are used more often than previous ones. This is due to the fact that they are already more balanced and suitable for a wide range of patients in need of enteral nutrition. Here, proteins are already in the form of amino acids and peptides, which makes them easier to digest in the body. Such solutions are used immediately after surgery in violation of the digestive function of the body. These include Nutrien Elemental, Nutrilon Pepti TSC, Peptorbis, Peptamen.
Standard polymer blends
This type is used in many diseases after surgery, when a person is in a coma. They are most suitable for the adult body in its composition. Such solutions contain all the necessary minerals, trace elements, proteins, fats, carbohydrates. They are divided into three types.
- Dry, which must be diluted and introduced into the body through a probe. This is the following enteral nutrition: Nutrizon, Berlamin Modular, Nutricomp Standard.
- Liquid that you can immediately enter. They are designed for situations where you can not lose a single minute, giving vital nutrition to a person. These include Berlamin Modular, Nutricomp Liquid, Nutrizon Standard and some others.
- Mixtures that are used orally. These are Berlamin Modular, Nutridrink, Forticrem and so on.
Directional mixtures
This type of nutrition is similar in purpose to the elemental form of mixtures. They are designed to restore the functionality of the body in a particular pathology. They correct metabolic disorders in respiratory failure, impaired renal and hepatic function, and immunity.