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The optimal method of providing enteral nutrition to critically ill patients remains controversial. In this Australian study, 73 intensive care unit patients were randomized to receive feedings either through nasogastric (NG) tubes or through nasojejunal (NJ) tubes placed endoscopically at the bedside. A protocol outlined criteria for stopping and restarting feedings when gastric residual volume exceeded preset thresholds.
Intolerance of feeding (defined prospectively) occurred in 13% of NJ patients and 31% of NG patients (P=0.09). NJ tubes were placed subsequently in 8 of 11 patients who were unable to tolerate NG feedings; 7 of these 8 tolerated NJ feedings. The NJ group had significantly lower mean gastric residual volumes than did the NG…