Q: When should nasogastric tubes be changed to feeding tubes?

A: Carol M. McGinnis, MS, CNS, CNSN, Pat Worthington, RN, MSN, CNSC, and Linda M. Lord, LMNP, MSN, CNSN, reply:

A convincing body of evidence linking improved outcomes to the use of enteral nutrition in critically ill patients has dramatically increased the use of feeding tubes in critical care. In the past, enteral feeding was not started until bowel sounds were audible, but current guidelines recommend starting enteral feeding as soon as the patient is hemodynamically stable, typically within 24 to 48 hours of admission to critical care.1,2  Although enteral feeding is without question the preferred route for providing nutritional support for critically ill patients, many questions concerning the most appropriate type of tube and the optimal location of the tip of the tube remain unanswered.

Factors related to the patient’s clinical status and treatment often present...

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