Nutrition support refers to any method of providing nutrients that will be assimilated and utilized by a patient other than oral feeding, such as artificial feeding via an IV line inserted in their stomach, intestine or vein.
Multiple healthcare practitioners are involved in providing nutrition care. Physicians lead the department and may oversee nurse practitioners, dietitians and pharmacists.
Artificial feeding
With parenteral nutrition therapy, nutrients are delivered directly into a patient’s bloodstream through tubes; either through enteral feeding into their gut for absorption (enteral feeding) or directly via central lines insertion and management. Patients requiring parenteral nutrition require specialist training in its use and insertion/managing.
At times, due to illness or swallowing issues, patients may not be able to eat enough. When this occurs, a naso-gastric tube (commonly referred to as an NG tube) will be placed through the nose and down into their stomach; for prolonged placements a percutaneous endoscopic gastrostomy (PEG) tube can also be surgically placed into their stomach.
tube feeding can cause many unpleasant side effects, including discomfort, bloating, diarrhea and agitation. There may also be risks such as infection, blood glucose control anomalies, hepatic dysfunction and volume overload that come with using tubes for nutrition.
Tube feeding
Tube feeding may provide those unable or unwilling to eat with access to necessary nutrition through liquid formula or meals consisting of various combinations of food and liquid, either at hospital or home.
Feeding tubes typically use the nasogastric (NG) tube, which travels through the nose, throat and esophagus before entering the stomach or small intestine. An alternative type of tube – known as nasointestinal or nasoduodenal or nasojejunal) passes from nose through throat and esophagus before entering first section of small bowel.
Patients receiving tube feedings in hospital typically receive written instructions on how to manage them at home, but those living in the community with nasal or duodenal tubes require care from a multidisciplinary team that includes a specialist nutrition support nurse as well as close collaboration between all healthcare professionals involved in their care – district nurses and homecare companies for example.
Nutritional products
Nutritional products are foods which contain nutrients that have been fortified or enhanced, such as bread fortified with iron and vitamins such as thiamin, riboflavin and niacin; citrus fruit beverages fortified with extra vitamin C to prevent goitre; salt with added iodine to decrease hypothyroidism; or nutritional supplements used in managing conditions like cancer or HIV/AIDS.
Nutrition support can be an effective treatment option in hospital settings for individuals suffering from protein-energy undernutrition and its complications, including depletion of body cell mass, decreased host defense functions and wound healing, and impaired responses to medical or surgical therapies. Unfortunately, its benefit in critical illness cases has been difficult to demonstrate due to limited available trials with good design; many concurrent treatments; poor methodology used by researchers in conducting trials; as well as their exclusion of older persons in trials conducted. Therefore it is imperative that healthcare professionals prescribing nutrition support have adequate skills and training within their specialty in this regard.
Other forms of support
Nutrition support (sometimes known as artificial or tube feeding) is used when an individual cannot receive enough nourishment from food alone. It usually involves inserting a tube directly into their stomach or small intestine for delivery of nourishment to their system. People in need of this form of help typically can’t swallow easily or have trouble digesting nutrients through their digestive tract, making eating alone difficult for them.
Nutritional support has made tremendous advances over the last three decades, with significant advancements in enteral and parenteral techniques, equipment, gastrointestinal access devices, formulations of nutrients and other related areas. Unfortunately, well-designed clinical trials comparing nutrition support with standard care have yet to demonstrate consistent benefits in older populations.
Multidisciplinary nutrition support teams typically include nurses, dietitians, pharmacists and physicians who collaborate on providing direct patient care as well as research activities. Their tasks may include nutrition assessment, prescribing and preparing enteral and parenteral formulas as well as educating healthcare providers, patients and caregivers as well as managing a nutrition support program – they may be located either independently or as an interdisciplinary team.
