DEPARTMENT= PRE-PHYSICIAN

TOPIC NAME - enteral and external ways of introduction of medical production

Indications for Enteral Nutrition

Malnourished patient expected to be unable to eat >5-7 days

Normally nourished patient expected to be unable to eat >7-9 days

Adaptive phase of short bowel syndrome

Increased needs that cannot be met through oral intake (burns, trauma)

Inadequate oral intake resulting in deterioration of nutritional status or delayed recovery from illness

Advantages—Enteral Nutrition Intake easily/accurately monitored Provides nutrition when oral is not

possible or adequate Supplies readily available Reduces risks associated with

disease state

Enteral Formulas Liquid diets intended for oral use or

for tube feeding Ready-to-use or powdered form Designed to meet variety of medical

and nutrition needs Can be used alone or given with foods

Contraindications for EN Inadequate resuscitation or

hypotension; hemodynamic instability

Ileus Intestinal obstruction Severe G.I. Bleed Expected need less than 5-7

days if malnourished or 7-9 days if normally nourished

Disease Specific FormulasDiabetic Blood glucose control in acute

care is often affected by illness, infection, other issues

Patients on enteral feedings generally receive a more consistent CHO intake than persons on oral diets

May be worth trying diabetes formulas in patients who have failed to achieve good blood glucose control on standard formulas

Enteral Formula Nutrient SourcesCarbohydrate CHO content ranges from 40-90%

of total calories Typically some combination of

hydrolyzed cornstarch, maltodextrins, corn syrup solids, sucrose

FOS: fructooligosaccharides; poorly absorbed in the small intestine, fermented in the large intestine; may promote growth of healthy bacteria

Fiber: soy polysaccharide (most common) guar gum, oat fiber, pectin

Closed vs Open SystemOpen System Hang time 8 hours for

decanted formula; 4 hours for formula mixtures

Feeding bag and tubing should be rinsed each time formula replenished

Contaminated feedings are associated with pt morbidity

Closed System Hang time 24-48 hours

based on mfr recommendations

Y port can be used to deliver additional fluid and modulars

May result in less formula waste as open system formula should be discarded p 8 hours

External Medical

• External Medical

AUBMC is committed to the establishment of strategic partnerships and collaborations locally, regionally, and internationally.

In order to be the leading medical institution in Lebanon and the region, AUBMC will have to be the institution of choice for partnership and collaboration in the region. AUBMC’s commitment to capacity building, locally and regionally, is unmatched by any other institution in the Middle East. AUBMC brings the highest standards of clinical car

• Over the past two years, these partnerships have offered AUBMC the opportunity to cater to its patients at various sites, to care for new patients at these hospitals, as well as to share complementary diagnostic services and equipment. Furthermore, these partnerships allow AUBMC to cater to patient populations that have limited access to AUBMC and are important for our training programs. To date, over 1,000 admissions have been made to these partnering hospital

• MissionThe EMA mission is to provide customer-centered assistance to health institutions/schools, open new opportunities and markets to the Faculty of Medicine/AUBMC in the areas of medical service, education, 

• The American University of Beirut (AUB) is an institution of higher learning founded to provide excellence in education, to participate in the advancement of knowledge through research, and to serve the peoples of the Middle East and beyond". At EMA, we are committed to cater for our associates'/clients' needs in medical services, education, and research.