Enteral Nutrition

Enteral nutrition delivers formula into the gastrointestinal tract when oral intake cannot safely or reliably meet nutritional needs. The goal is not simply to “get calories in.” It is to provide nutrition through a functioning gut while reducing the harms of prolonged inadequate intake. Enteral feeding may be considered when oral intake supplies less than about 60% to 80% of estimated energy needs for more than 10 days. It may also be used when the airway requires protection or when intestinal conditions such as short bowel syndrome or severe malabsorption make ordinary oral intake insufficient. A usable gastrointestinal tract does not mean every patient is ready for a feeding. Do not initiate enteral nutrition in gastrointestinal obstruction, perforation, uncontrolled gastrointestinal bleeding, a high-output fistula exceeding 500 mL/day, or severe hemodynamic instability such as uncontrolled shock. In shock, reduced gut perfusion means the bowel may not tolerate feeding; stabilization takes priority over nutrition delivery.