Feeding Comatose Patients

[Sir Robin Goodfellow]

When someone is in a coma, what method is used to supply the patient with nutrition? Do they place a tube directly into the stomach? What kind of food do they use?

 

[Criticalist]

Initially a nasogastric tube is placed which ends in the stomach. Some tubes can go further, into the jejunum. For patients who are thought likely to need very long term support, nasogastric tubes can cause problems - erosions on the nostrils, a chance of aspiration of stomach contents, etc, so the very long term patients may have a tube placed directly througth the abdominal wall into the stomach or small intestine. These are called PEGS - for PErcutaneous Gastrostomy.

There are a varierty of standard nasogastric feeds available which supply all the neccessary energy and vitamin requirements, and there isn't a lot of difference between them. Then can vary in calorie density, fibre and salt content and the like.

 

[Sir Robin Goodfellow]

Thank you. I was discussing this topic with someone who thought that they did this intravenously.

 

[Professor Yaffle]

Pareneral nutrition (which is given intravenously) is usually only given when the patient is not able to take nutrition by the oral/enteral route. For example when there is no functioning intestinal tract, or there is a disorder which needs bowel rest. It is sometimes used in comatose patients, but enteral nutrition is usually preferred as there are fewer complications.

My niece had TPN (total parenteral nutrition) when she in hospital due to a heart defect (she ended up getting a transplant) because she was losing weight when being fed by naso-gastric tube and it was very important to keep her strength up to cope with all her body was going through.