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Equipment of Enteral Nutrition
- Enteral feeding pumps
- Gravity sets
- Extension sets
- Feeding bag &irrigation kits
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The mode of EN administration depend on:
- Clinical condition of the patient (tolerance/diagnosis/age)
- Quality of life considerations
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Mode of EN administration
- Continuous feeding
- Intermittent/gravity feeding
- Bolus feeding
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Continuous feeding freatures
- at a steady rate at 5 - 600 ml / hr
- 18-24 hr
- Pumps
- break of 2-4 hours
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Continuous feeding Indications
- who can’t tolerate large volume
- progress > intermittent
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Cyclic continues feeding features
- 12-16 hours
- delivered overnight or during
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Cyclic continues feeding Indications
- long term EN (home enteral nutrition/in nursing homes)
- who cant tolerate large volumes
- transition > oral
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Intermittent/gravity feeding features
- pump or gravity drip
- 4-6 feeding/day
- 20-60 minutes
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Intermittent/gravity feeding indications
- Mobile patients
- Transition > oral feeding.
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Bolus feeding features
- using a 60 ml infusion syringe
- 4-6 times a day (or more)
- 5-20 minutes
- normal gastric function > tolerate up to 500 ml / feed
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Bolus feeding indication
- infant to mimic the pattern of breast feeding (physiological)
- transition > oral feeding
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initiation and advancement - Continues feeding Pre-term
- start > 0.5-1 ml/kg/hr
- advance > 10-20 ml/kg > day
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initiation and advancement - Continues feeding Pediatrics
- start > 1-2 ml/kg/hr
- advance > 0.5-1 ml/kg > 6-8hrs
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initiation and advancement - Continues feeding Adults
- start > 10-40 ml/hr
- advance > 10-20 ml > 8 hours
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initiation and advancement - Intermitted/Bolus feeding Pediatrics
- Initiated by 25%
- Increase volume by 25% > daily
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initiation and advancement - Intermitted/Bolus feeding Adults
- Initiated by 25% of goal
- Increase 60-120 ml > 8-12 hours
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Water flushes-Practice Recommendations
- 30 ml of water every 4 hours during continuous feedin
- before and after intermitted feeding in adult patients.
- After gastric residual volume measurements
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goals of monitoring EN
- To ensure compliance with the treatment plan
- Evaluating the adequacy of nutrient provision
- Detecting any potential complication as early as possible.
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monitoring EN include
- Feed administration
- feed tolerance
- fluid balance
- lab values
- efficacy of nutrition plan
- tube