Mark H DeLegge1. 1. Medical University of South Carolina, Charleston, South Carolina, USA. deleggem@musc.edu
Abstract
PURPOSE OF REVIEW: Enteral nutrition is a widely used therapy for nutritional treatment of patients with multiple pathologies. The present review selects important evidenced-based papers from 2006 and 2007 and critically reviews them for the reader. RECENT FINDINGS: Use of synbiotics and probiotics is gaining acceptance. Supplements such as glutamine may be important for wound healing. Enteral feeding in malnourished patients may result in rapid growth of gut mucosal protein. Antibiotics are important for reduction of postpercutaneous endoscopic gastrostomy infections. Early enteral nutrition in burn patients blunts the hypermetabolic response. Polymeric enteral formulations in vitro have a direct anti-inflammatory effect on enterocytes. Enteral nutrition, however, does not appear better than steroid use for induction of remission in Crohn's disease. Long-term (12-week) infusion of immune-enhancing enteral formulas in a nonsurgical patient group is well tolerated and safe. Finally, large reviews of enteral nutrition and their efficacy for specific disease states continue to demonstrate the difficulty in interpreting multiple small clinical studies. SUMMARY: Enteral nutrition continues as a highly used medical therapy, usually as an adjuvant for other pharmacologic and supportive therapies. Multiple small clinical trials, observational studies and retrospective reviews must be analyzed to develop 'best practice' guidelines with enteral nutrition.
PURPOSE OF REVIEW: Enteral nutrition is a widely used therapy for nutritional treatment of patients with multiple pathologies. The present review selects important evidenced-based papers from 2006 and 2007 and critically reviews them for the reader. RECENT FINDINGS: Use of synbiotics and probiotics is gaining acceptance. Supplements such as glutamine may be important for wound healing. Enteral feeding in malnourished patients may result in rapid growth of gut mucosal protein. Antibiotics are important for reduction of postpercutaneous endoscopic gastrostomy infections. Early enteral nutrition in burn patients blunts the hypermetabolic response. Polymeric enteral formulations in vitro have a direct anti-inflammatory effect on enterocytes. Enteral nutrition, however, does not appear better than steroid use for induction of remission in Crohn's disease. Long-term (12-week) infusion of immune-enhancing enteral formulas in a nonsurgical patient group is well tolerated and safe. Finally, large reviews of enteral nutrition and their efficacy for specific disease states continue to demonstrate the difficulty in interpreting multiple small clinical studies. SUMMARY: Enteral nutrition continues as a highly used medical therapy, usually as an adjuvant for other pharmacologic and supportive therapies. Multiple small clinical trials, observational studies and retrospective reviews must be analyzed to develop 'best practice' guidelines with enteral nutrition.