Nutrition provides adequate substrates, vitamins, minerals, and antioxidants for cell and organ metabolism. The maintenance of adequate nutrition is critical for preventing disease, and augmenting disease resolution. Unfortunately, there are times during a patient’s disease course when enteral nutrition cannot be used or is ineffective. At this time, parenteral nutrition may be implemented to provide enough macro- and micronutrients to sustain life and aid in disease recovery.

Multiple reviews and meta-analyses demonstrate the benefits of enteral nutrition, when compared to parenteral nutrition. Patients receiving enteral nutrition have decreased infectious and noninfectious complications. Their cell-mediated immunity is improved and they experience less organ failure, improved wound healing, and nitrogen balance. Active use of the intestinal mucosa helps to preserve its integrity. With the early use of enteral nutrition, these patients have a reduced need for ventilatory support, decreased intensive care unit (ICU) and hospital lengths of stay.

Enteral nutrition also has complications associated with its use. Mechanical complications are the most common. The feeding tube can become obstructed, inhibiting the flow of nutrition. Infection, at the site of tube entry is a persistent risk. The patient can also have difficulties with electrolyte balance and adequate hydration. Patients receiving enteral nutrition may also experience gastroesophageal reflux, aspiration, refeeding syndrome, and diarrhea.