คำศัConclusion
Obtaining gut access in order to provide enteral nutrition(EN) to critically ill and trauma patients is obligatory,whenever feasible, and is, in fact, the standard of care.Nonsurgical techniques include simple orogastric, nasogastric, or nasojejunal feeding tube placement. Invasive surgical techniques include an open gastrostomy, gastrojejunostomy, or jejunostomy; less invasive techniques include percutaneous endoscopic gastrostomy (PEG) and laparoscopically assisted or totally laparoscopic gastric or jejunal feeding tube placement. Surgeons and other physicians caring for critically ill and trauma patients need to be familiar with the array of techniques for gut access, including their potential benefits and complications. Such familiarity will ensure proper nutritional care for vulnerable patients. We recommend early gastric trophic feeding in critically ill and trauma patients whenever feasible, reserving postpyloric tube feeding for gravely ill patients. Further research is warranted in order to ensure the safety of surgically placed tubes in patients with an open abdomen.
Conflict of interest The authors declare no conflict of interest.
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