Guidelines for Enteral Feeding are important because it maintains the strength and viability of gut associated lymphoid tissue called GALT. This is important as the structure of the cells in the GALT or lymphoid tissue must remain stable. In addition this supports the mucus associated lymph tissues or MALT in order for function of lungs, kidneys, and liver. The criticality of proper nutrition to these organs is very time sensitive. Therefore clear guidelines as to Enteral Feeding are essential to aiding the sustenance of the life and viability of the patient (ASPEN, 2009). With proper Enteral Feeding the risk associated with bacterial infection is increased. This may trigger MODS or multiple organ dysfunctions. When a disease increases in severity, EN can provide sustenance to the organs to trigger immune response. Standardized guidelines ensures the same treatment for similar cases of illness. This reduces the uncertainty of prescribed treatment and also allows for the best solutions to be adopted for treating all patients due to their positive response (ASPEN, 2009).

Complications of Enteral Feeding are time sensitive. It is necessary to provide feedings within the first 24 to 72 hours of a metabolic breakdown. This allows the GALT and MALT to be fortified with nutrition to reduce gut permeability and minimize inflammation due to tumors or necrosis. There are even instances of fewer infections that lead to morbidity (Aspen, 2009). The initiation of EN is possible when fluid are being used to resusitate and the blood flow is normalized.

Compare to Assessment

Guidelines under Jellis Enteral tube feeding may be indicated when (2010):

Guidelines under Jellis Enteral tube feeding...

Nutrient intake by mouth is contraindicated (e. g. due to dysphagia) and the gastrointestinal tract is functioning.
-- stroke

-- unconsciousness/mechanical ventilation

-- motor neurone disease / multiple sclerosis

-- other chronic neurological disorders

-- head and neck cancer & surgery

-- recurrent aspiration associated with oral feeding

-- severe head injury

2. Oral intake does not meet normal requirements.

-- surgery

-- gastrointestinal disease

-- trauma

-- neurological disorders

-- cancer

-- side effects of drug treatment e. g. anorexia, nausea, sore mouth

-- chronic pain

3. Nutrient losses are increased.

-- inflammatory bowel disease

-- enterocutaneous fistula

-- chronic renal failure

-- malabsorption states

-- frequent diarrhoea

4. Nutrient requirements are increased.

-- large wounds e. g. pressure sores

-- pancreatitis

-- sepsis

-- metabolic diseases

-- chronic renal failure

-- burns

References

ASPEN Clinical Laboratories (2009). Guidelines for support of nutritional support therapy in adult nutritional therapy. Retrieved October 1, 2011 from http://www.nutritioncare.org/WorkArea/showcontent.aspx?id=3396

Jellis, J.A. (2010). Enteral Feeding Guidelines. Retrieved October 1, 2011 from https://www.ldh.nhs.uk/Ldh_nhs_website_documents/EMERGENCY_MEDICINE/enteralfeedingguidelines.pdf