Enteral nutrition continues to play an important role in the nutritional support of patients in an intensive care unit. Placement of feeding tubes through the pylorus (to supply enteral nutrition) nasally, percutaneously, or surgically does not eliminate complications, eg, aspiration pneumonitis. Furthermore, there are still no good ways to prevent stress-related mucosal damage that do not lead to bacterial overgrowth. Whether this overgrowth leads to nosocomial pneumonia, however, is controversial. If it does, it is probably not secondary to bacterial trandocation across the gastrointestinal tract. Mucosal atrophy with associated bacterial translocation has not been demonstrated to be as important in humans as it is in nonhumans. Studies of total parenteral nutrition emphasize line-related infection and electrolyte, trace element, carbohydrate, and fat composition of the parenteral formula.
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