Question

Mike requires a tube feeding to help him gain weight. Mike is wants to eat as much as he can by mouth. However, his oral intake is limited due to radiation treatments to his head/neck area and he can only tolerate small amounts of food in his stomach at one time. An optimal approach to nutrition support for Mike would be

A. TPN

B. Bolus Tube Feeding

C. Continuous Tube Feeding

D. Intermittent Tube Feeding

Answer 1

Let's understand the methods of nutrition mentioned here:

• Total Parenteral Nutrition : In this method, the entire gastrointestinal system is bypassed. It is useful in patients who are severely malnourished or have gastrointestinal obstruction of some sort which is preventing them from getting the required nutrition.
• Bolus Tube Feeding: As the name suggests, in bolus feeding, a bolus or a considerable amount of liquid food equivalent to a 'meal' is given via a syringe to the stomach. Administration of 200–400 ml of feed down a feeding tube over 15mins to one hour in fixed intervals is done. It is for people who can tolerate normal amount of food in their stomach.
• Continuous Tube Feeding: A continuous infusion of nutrients. It is reserved for severely I'll patients. Should be avoided in this patient as his neck movement is already compromised which can mean greater chances of aspiration.
• Intermittent Tube Feeding: Intervals of 4-6 hours as per the patient's needs are given.

According to the given information, Intermittent Tube Feeding would be ideal for Mike.