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Abstract
Although clinical and experimental evidence favours early enteral feeding in the critically
injured, provision of such enteral feeds can be difficult. Gastric feeds are often
not tolerated and may lead to aspiration. An intolerance of gastric feeds leads to
a cumulative energy and protein deficit and may result in the initiation of expensive
parenteral nutrition (TPN). An alternative and under-utilized technique to ensure
enteral access in trauma victims is the insertion of a transpyloric (nasojejunal)
feeding tube during emergent laparotomy. We have employed this method of enteral access
with success. In the following report, we describe this technique, provide an illustrative
case with a cost comparison between nasojejunal feeds and TPN, present the rationale
for such a mode of enteral access and outline the indications and contraindications.
Enteral access by the intra-operative insertion of a transpyloric feeding tube allows
immediate/early enteral feeding that is easy, safe, reliable and inexpensive.
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Article info
Publication history
Accepted:
November 22,
1994
Identification
Copyright
© 1995 Published by Elsevier Inc.
