Enteral nutrition

92 enteral nutrition products – tube feeds and sip feeds, foods for special medical purposes. Values per 1,000 ml as declared by the manufacturer.

92 products

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When enteral nutrition is indicated

Enteral nutrition – delivery of nutrients through a tube or stoma into the gastrointestinal tract – is indicated in malnourished or at-risk patients who cannot meet their needs orally, even with oral nutritional supplements, and who have a functional gastrointestinal tract.ESPEN Terminology 2017 · section 3.5.3.2; ESPEN Home EN 2020 · rec. 1; ESPEN ICU 2019 · rec. 41

It is considered when intake is expected to be insufficient for a week or longer (for example, less than 60% of requirements for 1–2 weeks). In critically ill patients who cannot eat, it should be started within 48 hours and preferred over parenteral nutrition.ESPEN Home EN 2020 · commentary on rec. 1; ESPEN ICU 2019 · rec. 4, 5; ESPEN ICU 2023 · no. 6, 7

Contraindications to enteral nutrition

These are contraindications to enteral nutrition as such, so we do not list them for individual products. According to ESPEN, enteral nutrition is withheld or delayed in:ESPEN Home EN 2020 · commentary on rec. 4; ESPEN Home EN 2022 · no. 4

  • bowel obstruction or ileus,ESPEN Surgery 2021 · commentary on rec. 7; ESPEN Home EN 2020 · rec. 4; ESPEN ICU 2019 · rec. 46
  • uncontrolled shock until haemodynamic and tissue perfusion goals are reached – once shock is controlled with fluids and vasopressors or inotropes, low-dose feeding can start while watching for signs of bowel ischaemia,ESPEN ICU 2019 · rec. 38; ESPEN ICU 2023 · no. 11; ESPEN Surgery 2021 · commentary on rec. 7
  • bowel ischaemia, severe functional bowel disturbance or severe malabsorption,ESPEN ICU 2019 · rec. 38; ESPEN Surgery 2021 · commentary on rec. 7; ESPEN Home EN 2020 · rec. 4
  • active gastrointestinal bleeding – feeding can start once bleeding has stopped and there are no signs of re-bleeding,ESPEN ICU 2019 · rec. 38; ESPEN Home EN 2020 · rec. 4; ESPEN Surgery 2021 · commentary on rec. 7
  • uncontrolled, life-threatening hypoxaemia, hypercapnia or acidosis and severe metabolic imbalance – feeding can start with stable hypoxaemia and compensated or permissive hypercapnia and acidosis,ESPEN ICU 2019 · rec. 38; ESPEN Home EN 2020 · rec. 4
  • high-output fistula without reliable feeding access distal to it, abdominal compartment syndrome, and gastric aspirate volume above 500 ml per 6 hours.ESPEN ICU 2019 · rec. 38; ESPEN Surgery 2021 · commentary on rec. 7; ESPEN ICU 2019 · commentary on rec. 13–14

Sources

  • ESPEN Terminology 2017 – Cederholm T, et al. ESPEN guidelines on definitions and terminology of clinical nutrition. Clin Nutr. 2017;36:49–64. doi:10.1016/j.clnu.2016.09.004
  • ESPEN Home EN 2020 – Bischoff SC, et al. ESPEN guideline on home enteral nutrition. Clin Nutr. 2020;39:5–22. doi:10.1016/j.clnu.2019.04.022
  • ESPEN ICU 2019 – Singer P, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019;38:48–79. doi:10.1016/j.clnu.2018.08.037
  • ESPEN ICU 2023 – Singer P, et al. ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit. Clin Nutr. 2023;42:1671–1689. doi:10.1016/j.clnu.2023.07.011
  • ESPEN Home EN 2022 – Bischoff SC, et al. ESPEN practical guideline: Home enteral nutrition. Clin Nutr. 2022;41:468–488. doi:10.1016/j.clnu.2021.10.018
  • ESPEN Surgery 2021 – Weimann A, et al. ESPEN practical guideline: Clinical nutrition in surgery. Clin Nutr. 2021;40:4745–4761. doi:10.1016/j.clnu.2021.03.031

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