Snapshot A 69-year-old male experienced an acute ischemic stroke and is now suffering from dysarthria and dysphagia. In order to reduce the risk of aspiration pneumonia and other complications from his poor swallowing ability, his treating team elects to temporarily place a nasogastric tube to deliver nutrition until he regains sufficient swallowing ability or another method of nutrition is pursued. Introduction Enteral feeding = any route of feeding that utilizes the patient's GI tract to deliver apporpriate nutrition (differs from parenteral nutrition, which delivers nutrition intravenously, completely bypassing the GI tract) Enteral nutrition is preferred to parenteral nutrition whenever feasible - if the GI tract is functional, use it - benefits include improved absorption, immunological benefits, and helps maintain a healthy and functional GI tract poor enteral feeding is common in the elderly or those with risk factors (dementia) Routes of enteral feeding: nasogastric tube orogastric tube nasoenteric tube (nasoduodenal or nasojejunal) oroenteric tube (oroduodenal or orojejunal) gastrostomy tube jejunostomy tube Indications Use for patients with a functioning GI tract that is having difficulty eating difficulty swallowing secondary to stroke, esophageal obstruction, advanced dementia, etc (enteral feeding can bypass the esophagus and deliver food to the distal GI tract, reducing the risk of aspiration pneumonia, etc) unconscious or comatose patients postoperative patients with surgery who are not tolerating oral intake within a reasonable period of time after surgery partial intestinal failure anorexia nervosa Complications Complications related to tube placement/acces OR metabolic abnormalities: Refeeding syndrome Blockage of feeding tube Irritation/ulceration of the proximal GI tract Peristomal infections Hypo-/hyperglycemia (monitor plasma glucose levels) Electrolyte abnormalities - need close monitoring of lab values Volme overload Enteral tube feeding-related diarrhea Aspiration Bacterial contamination of feeds leading to sepsis and/or other infections