In life there are different situations when an adult cannot eat in the usual way. This happens mostly after surgery. During the recovery period, a person is unable to chew and rise to digest food. But also at this time, the patient needs a constant supply of nutrients to the body for the functioning of all organs and the restoration of life. In this case, such a type of food intake as enteral nutrition is used.
Enteral nutrition - what is it?
This is a kind of patient therapy, its peculiarity is that the food comes through a probe or a special system. Most often, with this type of food, special mixtures are used. They are different from normal food for an adult, as in certain conditions the patient cannot take other foods.
The benefits of this diet
This type of food has its benefits for the sick:
- Physiological - nutrition passes directly to the digestive organs, which allows it to be easilybe absorbed and give strength to the patient after the operation.
- Cheap food - this method doesn't cost too much.
- Easy to use add-ons - no high sterility requirement as simply reprocessing an enteral feeding tube or oral formula system.
- Does not cause serious complications - the probe is inserted without any problems, so there is no chance of development and occurrence of life-threatening complications for the patient.
- Allows you to provide the body with all the necessary substances, this is due to the selection of mixtures that are optimal for a person.
- Helps prevent the occurrence of atrophic phenomena in the gastrointestinal tract.
Indications for enteral nutrition
The development of medicine in the last two centuries has made it possible to determine what will be best for a person after surgery, methods that will help him recover faster and get the necessary strength with the least risk. So nutrition with mixtures after operations 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 very method of eating. Artificial nutrition is given if:
- The patient, due to his condition, cannot eat when he is unconscious or unable to swallow.
- The patient should not eat food - this is a condition of acute pancreatitis or bleeding in the gastrointestinal tract.
- Sicka person refuses food, then forced enteral nutrition is used. What is it when such a state arises? This happens with anorexia nervosa, in which it is impossible to immediately load the stomach with ordinary food, since there is a danger of death after a long absence of food. Also, with various infections, the patient may refuse to eat, in which 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 there is no way to ensure the intake of these substances in a natural way;
- in the event of various neoplasms in the head, stomach and neck;
- if there are progressive diseases of the central nervous system, such as Parkinson's disease, cerebrovascular stroke, various states of unconsciousness;
- for oncological conditions after radiation and chemotherapy;
- often such food is prescribed for severe diseases of the gastrointestinal tract: pancreatitis, pathological processes in the liver and biliary tract, malabsorption and short bowel syndromes, as well as Crohn's disease;
- immediately after surgery on the body;
- for burns and acute poisoning;
- when fistulas, sepsis appear;
- if complexinfectious diseases;
- for severe depression;
- with varying degrees of radiation damage to humans.
Methods of feeding formulas
Enteral nutrition of patients differs by the way they eat:
- Using a tube to introduce formula into the stomach.
- The "sipping" method of eating special foods orally in small sips.
These methods are also called passive and active. The first is enteral tube feeding, infusion occurs using a special system and a dispenser. The second is active, manual, carried out mainly with a syringe. To use this method, it is necessary to collect a certain amount of the mixture and inject gently into the oral cavity of a sick person. To date, the advantage is given to infusor pumps, which automatically supply the mixture.
Enteral feeding tubes
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 holes at a certain level, as well as weights for ease of insertion;
- percutaneous - inserted after surgery (pharyngoscopy, gastrostomy, esophagostomy, jejunostomy).
Modes of nutrition for the body
Understanding this issue, enteral nutrition - what it is, is not yet 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 receiving nutrition by the patient.
- Feed mixture at a constant speed. Through the probe, the patient receives food at a certain rate, it is 40-60 ml / h. Then the specialist monitors 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 within 8-12 hours, then during the same time you can add the same amount until the required speed is reached. If the operation has just passed and the patient is in serious condition, the mixture should be administered no more than 20-30 ml / h. It is necessary to carefully monitor the condition of a person. 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 cyclic nutrition consists in the fact that the patient, after continuous nutrition, is gradually reduced at night, reducing it to a break for the night. This method is convenient for the patient and can be done through the gastrostomy.
- Session nutrition (periodic) is not for everyone. It is indicated for those patients who have diarrhea or have undergone gastrointestinal surgery. Such a meal is called periodic, as it is carried out in periods of 4-6 hours.
- Bolus meals. This mode is similar tonormal meal. The mixture is injected with a syringe or through a probe, but the rules for entering are strictly observed. At the same time, the speed does not exceed 240 ml per half hour. The number of meals per day 3-5 times. But it is worth starting the introduction of the mixture with a hundred ml. If the patient tolerates it without problems, then 50 ml is gradually added. But this regimen is dangerous due to the frequent occurrence of diarrhea, so it should be prescribed and carried out under the supervision of a specialist.
Of course, these regimens cannot be adjusted to 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
Enteral nutrition formulas should also be tailored to individual patient needs. Their choice depends on several factors.
- Quality nutrition for postoperative patients should have good energy density. It is not less than 1 kcal/ml.
- The formula must be lactose and gluten free. These substances can cause allergies.
- It should have an osmolarity of no more than 340 mosm/L.
- Food should be non-viscous to avoid absorption problems.
- A quality formula does not cause excess intestinal motility.
- It is necessary that it contain information about the manufacturer and the presence of a 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 cannot 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 blends
The name of 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 s alts, which makes it possible to restore the functionality of the small intestine immediately after surgery. In the presence of vomiting or diarrhea, such nutrition well maintains the water and electrolyte balance in the human body. These mixtures include Gastrolit, Mafusol, Regidron, Citroglucosolan, Orasan and some others.
Elemental food mixes
This patient nutrition pack is formulated with 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, therefore such mixtures help a person at least partially restore vital activity. This type of food includes Vivonex, Flexical, Lofenalak and others.
Semi-Element Blends
These nutritiousmixtures for patients are used more often than the previous ones. This is due to the fact that they are already more balanced and suitable for a wide range of patients requiring enteral nutrition. Here, proteins are already in the form of amino acids and peptides, which allows them to be more easily absorbed in the body. Such solutions are used immediately after operations in violation of the digestive function of the body. These include Nutrien Elemental, Nutrilon Pepti TSC, Peptisorb, Peptamen.
Standard polymer blends
This type is used for many diseases after operations, when a person is in a coma. They are the most suitable for an adult body in their 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 injected into the body through a tube. This is the following enteral nutrition: "Nutrison", "Berlamin Modular", "Nutricomp Standard".
- Liquid that can be administered immediately. They are designed for situations where there is not a minute to lose, supplying 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 blends
This type of nutrition is similar in purpose to elementalkind of mixtures. They are designed to restore the functionality of the body in a specific pathology. They correct metabolic disorders in respiratory failure, impaired kidney and liver function, and immunity.
