Tube feeding

Intensive care unit

Feeding tubes are often used in the intensive care unit (ICU) to provide nutrition to people who are critically ill while their medical conditions are addressed. Those who are critically ill have decreased nutrient intake, reduced nutrient utilization and increased inflammation and metabolic needs. Malnutrition in critically ill people is associated with death, prolonged hospitalizations, and hospital readmissions. In critically ill people who have malnutrition or at risk of the disorder, individualized medical nutrition therapy (MNT) with a dietician is the preferred initial treatment. MNT involves a nutritional assessment, patient counselling to increase nutritional intake, oral nutritional supplements and if required; tube feeds or total parenteral nutrition (TPN). In critically ill patients, MNT (including tube feedings if needed) was associated with a lower risk of death, with a 27% lower risk of death up to 6 months after hospital discharge, lower risk of hospital readmission, increased weight, and increased protein and caloric intake. Tube feeding is preferred over TPN. High protein tube feedings in the ICU have found no benefits as compared to standard feeding, and in some cases was associated with harm. Early tube feeding (within 24 hours of hospital admission) may also not be beneficial.