Methods of Enteral Nutrition

- EN can be administered by different methods depending on the patient’s tolerance, nutritional needs, and type and location of the tube.

- EN methods can be classified into four main types:

• Bolus method: This involves rapidly delivering 250 to 400 mL of formula through a syringe or funnel into the tube four to six times a day. This method takes about 10 minutes per feeding and mimics normal meal patterns. This method is suitable for gastric tubes only and may cause nausea, vomiting, aspiration, abdominal cramping, or diarrhea in some patients.
• Intermittent method: This involves delivering 300 to 400 mL of formula over 30 to 60 minutes by gravity drip or pump infusion every 3 to 6 hours. This method uses a feeding bag and allows for more flexibility and mobility. This method is suitable for gastric or intestinal tubes and may cause similar complications as the bolus method in some patients.
• Continuous method: This involves delivering a constant rate of formula over 8 to 24 hours by pump infusion. This method uses a feeding bag and requires close monitoring and frequent flushing of the tube. This method is suitable for intestinal tubes or patients with poor tolerance to other methods and may cause fewer complications than the bolus or intermittent methods in some patients.
• Cyclic method: This involves delivering a higher rate of formula over 8 to 16 hours, usually at night, by pump infusion. This method uses a feeding bag and allows for more freedom and oral intake during the day. This method is suitable for gastric or intestinal tubes or patients who are transitioning from EN to oral nutrition and may cause similar complications as the continuous method in some patients.