EN, TPN, refeeding syndrome

11 important questions on EN, TPN, refeeding syndrome

When do you start tube feeding

If optimal oral intake is insufficient or impossible

Which 4 types of tube feeding is there

Nasogastric
nasoduodenal
PEG
jujunostomy

What 3 types of complications are there with tube feeding?

Gastro-ointestinal: nausea, constipation, vommiting, diarrea, reflux
tube: misplacement, perforating bowel, tubo occlusion, tube irritation (nose, throat)
metabolic: hypo or hyperglycemia, disruption electrolytes, deficiencies.
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What is the definition of intestinal failure?

reduction of gut function below the minimum required for the assorption of macro and micro nutrients, such that intravenous supplementation is required

What is type 1 intestinal failure?

Acute and short term IF, few days or week.

What is type 2 Intestinal failure?

Prolonged acute condition, few weeks or months.

What is type 3 intestinal failure?

chronic condition. Can take years, may be reversable or not.

Which nutrition do you give with type 1 intestinal failure?

TPV in hospital

Which nutrition do you give with type 2 intestinal failure?

short-term TPV at home

Which nutrition do you give with type 3 intestinal failure?

Long-term TPV at home

Which 3 catheter types for TPN are there?

Peripheral TPN (PPN): short term, 1-3 days, in underarm
central TPN: long term, >1 week, collarbone
catheter tunneled TPN:  home TPN, permanent

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