Nasogastric tube feeding at home: a method for adjunctive nutritional support of malnourished patients

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Abstract
Many patients with chronic diseases develop malnutrition. Force feeding with either enteral tube or parenteral infusions often succeeds in ameliorating this problem in hospitalized patients. However, after discharge many patients are incapable of sustaining adequate dietary intake. As a consequence, malnutrition may persist or recur. The authors' previous experience using nocturnal enteral tube feedings in patients with glycogen storage disease suggested that malnourished patients also might benefit from enteral tube feedings at home. Fourteen undernourished patients selected for domestic enteral tube feedings clearly demonstrated a tolerance, which included adequate gastric emptying, to the infusions during their hospitalization. They ranged in age from 2 months to 68 yr. Infusion pumps delivered the feedings continuously. At home, 12 patients experienced substantial weight gains. Two maintained their weight while they received intensive chemotherapy for malignancies. Except for the two patients with short bowel syndrome, all patients were weaned successfully to oral feedings after 1 to 3 months. The only apparent complication was possible aspiration pneumonia in a patient with neurological dysfunction. This further experience with domestic enteral tube alimentation indicates that selected patients can be managed effectively, safely and economically with nasogastric nutritional support on an outpatient basis.