Enteral feeding: techniques of administration.

The objective of nutritional support is to provide sufficient nutrients to maintain or improve nutritional state.' These aims may be difficult to achieve using enteral nutrition2 as positive nitrogen balance may not be established consistently throughout a course.3 This finding has little to do with the formulation of the diet itself as up to one third of a prescribed diet may never reach the patient.2 4 Although much emphasis has been placed on the absorption characteristics of various substrates used in enteral feeds, their full potential can only be achieved if proper attention is paid to the more mundane subject of their administration. It is essential that the complete volume prescribed reaches the small bowel while minimising feed related complications such as vomiting, aspiration, diarrhoea and ostomy losses. Equipment must be safe, simple, and inexpensive. Greater emphasis than hitherto must be placed on the training of medical and nursing staff in nutritional support techniques. The choice of equipment should be rationalised according to local requirements, preferably under the auspices of a "nutrition team."