• U Suchner, U Senftleben, J Askanazi, and K Peter.
• Institut für Anaesthesiologie, Klinikum Grosshadern, Ludwig-Maximilians-Universität, München, BRD.
• Infusionsther Transfusionsmed. 1993 Apr 1;20(1-2):26-37.

ObjectiveThe purpose of this article is to review the facilities of early enteral nutrition in critically ill patients.Data SourcesReview articles as well as original papers are the main sources for this contribution.Selection CriteriaPathophysiologic conditions of intestinal substrate assimilation during hypermetabolism are described. The resulting consequences for enteral alimentation are discussed. Practical aspects such as classification and different indications of formulas, performance of enteral nutrition as well as management of tube feeding complications are further subjects of this review.ResultsPaying attention to tolerance, enteral nutrition can be started early in the postoperative or posttraumatic course. Jejunal substrate application, however, reveals to be a major issue for successful management.ConclusionClinical performance as well as efficiency of enteral nutrition seem to be essentially dependent on the intestinal blood flow. New methods for estimating intestinal blood flow, such as tonometry, will have to be evaluated especially in critically ill patients to improve the indications for enteral nutrition.

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