Abstract
This retrospective study examined the tolerance of enteral nutrition in 32 of 67 consecutive, neurosurgical patients placed into pentobarbital-induced coma for intractable intracranial hypertension. Patients who had received at least 4 days of enteral nutrition were included. Patients with <4 days of enteral nutrition were excluded for reasons unrelated to feeding tolerance. All patients were fed by a 10-French, small-bore feeding tube placed blindly or endoscopically. Feeding-tube location was in the small bowel in 26 of 32 patients, intragastric in 4 patients, and not documented in 2 patients. Intolerance (>500 ml watery stool for 2 days, abdominal distention, or duodenal-gastric reflux) was observed in 3 of 32 patients. The patients received daily, on average, 92% ± 24% calories of their measured energy expenditure. This study demonstrates that patients placed into barbiturate coma can be successfully fed by the enteral route.
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