How do critically ill or injured patients receive nutrition?
Due to a critical illness or injury, some ICU patients
cannot eat in the usual fashion. Therefore, nutrition is
often given to patients in the ICU through feeding tubes or
intravenously. The preferred way to provide nutrition to ICU
patients is through the feeding tube. However not all ICU
patients can receive nutrition through a feeding tube and
they must be fed intravenously.
How are tube feedings given?
Liquid tube feedings may be given to patients through
nasogastric, nasoduodenal, gastrostomy, or jejunal tubes.
These tubes provide access to the stomach or small
intestines for feeding. Tube feeding may be given through
these tubes at a constant rate over a twenty-four hour
period or by specific amounts given periodically through a
twenty-four hour period. Often a feeding pump is used to
assure that the specified amount of tube feeding is
delivered over the twenty-four hour period. Liquid tube
feedings are typically seen at the bedside hanging from an
IV pole infusing through the feeding pump. The tube feeding
solution is usually changed or adjusted every twenty-four
hours.
What type and how much tube feeding
is given?
A number of tube feeding products are available. The doctor,
dietician, pharmacist, and nurse will help to decide what
each individual patient requires. Fortunately liquid tube
feedings are very complete and include: protein, fat,
carbohydrates, and vitamins. Recently, specialized tube
feedings have become available that enhance the healing of
ICU patients with certain conditions. If you have further
questions regarding nutritional issues you should talk to
the nurse or doctor.
Do tube feedings hurt?
Tube feedings usually do not hurt and most ICU patients do
not realize that they are receiving tube feedings unless
they are told. Occasionally patients may develop cramping,
diarrhea or nausea when receiving liquid tube feedings.
How long are tube feedings needed?
Tube or intravenous feedings are necessary until the patient
is able to consume appropriate amounts of nutrition by
eating.
When and how are intravenous
feedings given?
Intravenous feedings are given to patients who are unable to
tolerate tube feedings. The medical staff will refer to
intravenous feedings as TPN (total parenteral nutrition) or
PPN (peripheral parenteral nutrition). TPN must be given
through a central venous catheter and the PPN may be given
through a regular IV. Similar to tube feedings, the
intravenous feeding provides the patient with the complete
amount of protein, carbohydrate, aft, and vitamins.
Intravenous feeding will be seen at the bedside hanging from
an IV pole infusing through an IV pump. If the intravenous
feeding has fat added to it, it will look white.
Does intravenous feeding hurt?
Intravenous feeding does not hurt and patients do not know
if they are receiving it unless they are told.
Are there any potential
complications associated with use of intravenous feedings?
The doctor, dietician, pharmacist, and nursing staff will
closely monitor patients receiving intravenous feedings.
Electrolytes, liver function, and glucose may be effected in
patients receiving intravenous feeding. Not uncommonly, a
patient's glucose will be temporarily elevated while
receiving intravenous feeding and they may require treatment
for the elevated glucose including insulin. This may occur
in patients who are not known to be diabetic.
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Feeding tube (black arrow) |
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Intravenous feeding (total parenteral
nutrition - TPN) |
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Nutrition 
