External metabolic balance studies during nasogastric feeding in serious illnesses requiring intensive care.

The importance of nasogastric feeding in serious illness was first appreciated by John Hunter in 1776, and in 1790 he achieved complete nasogastric alimentation for 18 days in a man with paralytic dysphagia (Hunter, 1837). A tube feed of milk powder (Complan) and lactose was recently described which maintained metabolic balance in patients with a variety of serious illnesses in an intensive-care unit (Jones and Sechiari, 1963). In patients with respiratory failure requiring intermittent positive-pressure ventilation (I.P.P.V.) that diet was complicated by an incidence of diarrhoea approaching 20-% (Jones and Peaston, 1966). This paper describes a modified tube feed in which external metabolic balance data confirmed its capacity to maintain metabolic balance and with which diarrhoea was less frequent.