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World Rev Nutr Diet. 2013;105:43-9. doi: 10.1159/000341265. Epub 2012 Oct 12.

Oral feeding.

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Dietetic Department, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain.


Early nutrition can help to improve energy and protein intake and decrease the negative impact of the metabolic response to surgery. A key goal is to identify patients who exhibit increased respiration risk before beginning oral alimentation. Once a simple bedside 3-oz (90 ml) challenge, or early intervention in the oral care, administered by a trained provider is passed, specific diet recommendations can be made safely and confidently without the need for further objective dysphagia testing. Gastrointestinal motility disorders occur as part of the pathophysiology of diseases and critical illness, or are a result of medication therapies or enteral feeding complications. Inadequate energy intake in the first 7 days following extubation have recently been described. It would be highly beneficial to determine when it is best to initiate timely oral alimentation for recovering extubated intensive care unit (ICU) and more specifically surgical ICU patients to support the maintenance and rebuilding of lean body mass, maintain hydration, and permit the ingestion of oral medications. In a cross-sectional multicenter study conducted in 18 Spanish ICUs, within the scope of the 2007 European Nutrition Day, only 95 of 348 investigated patients (27.3%) received oral nutritional support. Constipation and diarrhea were common adverse effects. Unexpectedly, however, constipation episodes were more frequent than diarrhea in the patients not receiving oral nutritional support.

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