Fascicolo monotematico "La Nutrizione Artificiale"
What’s needed when a child is malnourished and his bowel works? Indications and complications of enteral nutrition
Sergio Amarri, Paola Accorsi, Simona Ghittini
1Team Nutrizionale Pediatrico Azienda Ospedaliera Santa Maria Nuova, IRCCS, Reggio Emilia
Enteral nutrition (EN) support involves both the delivery of nutrients via feeding tubes and the provision of specialised oral nutrition supplements. EN is indicated in a patient with at least a partially functioning digestive tract when oral intake is inadequate or intake of normal food is inappropriate to meet patients’ needs. Whenever possible intragastric and intermittent feeding is preferred to post-pyloric delivery of nutrients. An expected duration of EN exceeding 4-6 weeks is an indication for gastrostomy or enterostomy. Among the various available gastrostomy techniques, percutaneous endoscopy gastrostomy is currently the first option. Both patients and caregivers take great advantages of this procedure, although it is associated with a number of well recognised, and most often minor complications. It is strongly recommended a development and application of procedural protocols, and regular monitoring by a multidisciplinary nutrition support team to obtain best effectiveness and minimise the risk of complications.