Academic literature on the topic 'Nasogastric tube feed'

Necrotizing enterocolitis is a common and serous disease predominantly affecting premature newborns, with an incidence, morbidity, and mortality that has remained unchanged for several decades. Around 7% of infants between 500g and 1500g birth weight are affected, with the disease often manifesting with vomiting, bilious aspirates, distended abdomen, and blood in stools around 8–10 days of age. Medical management includes decompression of the gastrointestinal tract via a nasogastric tube, broad-spectrum antibiotics, and bowel ‘rest’ (total parenteral nutrition). Surgical intervention is requir

This chapter describes historic steps in feeding techniques and knowledge about the nutritional needs of premature infants. Devices to overcome weak sucking and swallowing were developed from 1851 to 1920: tube feeding by gavage, medicine droppers and pipettes, feeding bottles with air inlet, and beaked spoons for nasal feeding. Indwelling nasogastric tubes were in use from 1951. For alleged safety concerns, postnatal feeding was postponed until a week of starvation was reached in the 1950s and studies showed an association with neurological handicaps. The premature infant’s elevated need for energy, protein, and minerals has been known since 1919. However, nutritional practice lagged behind theoretical knowledge. Concentrated formula was developed in the 1940s, parenteral supplementation in the 1960s, and human milk fortifiers in the 1970s. In the 1990s, necrotizing enterocolitis was found to be more frequent in infants fed formula than in those fed human milk. Recently, probiotics were shown to reduce the risk of necrotizing enterocolitis. Compared to other aspects of neonatal medicine, there is little evidence on how to feed preterm infants.

The clinical nutrition chapter is related to nutritional support provided in a number of ways, including enteral and parenteral. It is important for the nurse to understand the care of feeding tubes, such as nasogastric feeding tubes and gastrostomy tubes. There is discussion about short-term and long-term enteral feeding as well as administration of drugs and feed. There is an in-depth exploration of parenteral nutrition that includes catheter access, catheter insertion, and catheter care. There can be issues with clinical nutrition, such as problems associated with feeding termed refeeding syndrome. Succinct discussion related to clinical nutrition can be useful within clinical environments by the nurse.

This chapter discusses the type of work caregivers do. Among the medical procedures that caregivers do that are mentioned in the chapter are: intravenous therapies (IVs), total parenteral nutrition (TPN), gastrostomy tubes (G-tubes) and nasogastric tubes (NG-tubes), urinary catheters, external catheters, intermittent catheters, wound care, ostomy, bowel management programs, respiratory procedures, tracheostomy, and positive-pressure ventilators. The chapter discusses caregiver insights and the dilemmas they face in having to provide skilled care. In general, many of the medical procedures are not only difficult to master but also cause trepidation because of the possible complications that can result if the caregiver makes a mistake. Several caregivers who gave IVs said they worried about contaminating the IV site or shooting air in the line. In hospitals, problems with medication administration are a leading cause of death, and so are infections that occur when a wound is not correctly dressed or an IV carefully accessed. Yet family caregivers are asked to do these activities on a routine basis — over a period of months or even years. The worry about complications is well founded, as they can have deleterious consequences. Coupled with issues of anxiety and fear of causing harm to the care recipient are issues of manual dexterity and “getting the feel” of the procedures. Not only do caregivers have to overcome fear, get the feel of procedures, and make sure they are done correctly, but they also have to get past the personal discomfort they may have regarding the intimate nature of the work they are asked to do.

Major vascular events involving the superior mesenteric artery and small-bowel volvulus are the commonest reasons for adults to require massive intestinal resection. The ability of the residual bowel to adapt after resection varies greatly between patients, but common postoperative problems include sepsis, diarrhoea (or high-output stoma losses), fluid and electrolyte imbalance, malnourishment (protein–energy malnutrition, mineral and vitamin deficiencies), gallstones, renal stones, and psychological illness. Where appropriate, oral nutrition, initially consisting of low-volume polymeric feeds administered by nasogastric or enteral tube, should be started within the first few days of surgery. Small-volume, frequent, solid or semisolid meals with low long-chain triglycerides and (when colon is in continuity) oxalate content should be introduced subsequently, and isotonic electrolyte solutions given as required. Oral multivitamin and mineral supplements are usually needed, and vitamin B₁₂ injections may be required. There should be regular long-term monitoring of fat-soluble vitamins (A and D), vitamin B₁₂, folate, magnesium, zinc, and bone status. Long-term intravenous nutrition is sometimes needed. Growth factor administration, especially glucagon-like peptide-2 analogues, may stimulate bowel adaptation. Small-bowel lengthening may be considered for patients with dilated bowel close to the length required. Those who are dependent on peripheral nutrition and develop complications such as loss of venous access or liver disease should be considered for intestinal transplantation.

Background: Management of life threatening complications encountered in Advanced Cancer is an important domain of Palliative Oncology. Malignant Bowel Obstruction is usually an indicator of poor prognosis in Advanced cancer. It is usually associated with malignancies in the gastrointestinal tract or those outside the gastrointestinal tract (gynaecological malignancies). MBO can also occur with primary peritoneal as well as secondary peritoneal malignancies. Diagnostic criteria for MBO include Clinical evidence of bowel obstruction, obstruction distal to the Ligament of Treitz, presence of prim