McClave Stephen A
Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA.
J Clin Gastroenterol. 2006 Nov-Dec;40(10):870-90. doi: 10.1097/01.mcg.0000225588.63083.c9.
The route, timing, and volume of enteral feeding delivered to a patient in the intensive care unit have a profound effect on clinical outcome. At the height of critical illness, problems with ileus, aspiration, and the systemic inflammatory response syndrome make the provision of enteral nutrients a difficult and somewhat risky endeavor. The gastrointestinal endoscopist has the technical skills to place feeding tubes deep within the jejunum and an underlying expertise in gut physiology to monitor patients effectively once feeds are initiated. Attention to detail in the techniques for attaining enteral access, early identification of potential problems, and quick institution of simple endoscopic strategies help improve delivery of nutrition support, minimize the likelihood for in-hospital complications, and optimize patient outcome.
在重症监护病房，给予患者肠内营养的途径、时机和量对临床结局有深远影响。在危重病的高峰期，肠梗阻、误吸和全身炎症反应综合征等问题使得提供肠内营养成为一项困难且存在一定风险的工作。胃肠内镜医师具备将饲管置入空肠深部的技术能力，以及在开始喂养后有效监测患者的肠道生理学专业知识。在获得肠内通路的技术上注重细节、早期识别潜在问题以及迅速采用简单的内镜策略，有助于改善营养支持的提供，将院内并发症的可能性降至最低，并优化患者结局。
