Nutritional support type
The type of nutritional support to be used depends on the possibility to use the gastrointestinal tract. Contraindications for EN arc: mechanical obstruction, mesenteric ischemia o intestinal failure, which includes less than 150cm of remaining and functional bowel, radiation enteritis, high output (>2L/day) proximal fistula (duodenum or jejunum), active inflammatory bowel disease and splanchnic ischemia24.
The first type of nutritional support to be considered is EN4,5'6-7. Even if PN has been started a daily assessment of EN start should be done7.