The adequacy of enteral nutrition

Patients who were previously considered candidates for total parenteral nutrition are increasingly being considered as suitable for enteral feeding. This change has occurred for physiologic (trophism of intestinal luminal nutrients), pathophysiologic (possible reduction in bacterial translocation), or economic (enteral feeds are cheaper) reasons. Although the obvious inadequacies in the technique are being resolved leg, by percutaneous gastrostomy feeding), there is much suboptimal practice in identifying malnourished patients, in formulation of diets and their amino acid adequacy, and in addition of the so-called ''novel substrates'' tie, glutamine, arginine, and nucleotides) to diets. Furthermore, the cost benefit of feeding those patients who require extensive hospitalization, by the enteral rather than the parenteral route, may prove illusory.