Part of “CHAPTER 124 – PRINCIPLES OF NUTRITIONAL MANAGEMENT“

The use of enteral feeding (through a nasogastric, gastrostomy, or jejunostomy tube) and parenteral feeding (through a central or peripheral vein) has increased steadily in hospitalized patients as complication rates have decreased and the importance of optimal nutritional support has been recognized.85,86,87 and 88 Further, patients with chronic diseases often are maintained as outpatients with enteral or parenteral nutritional support. With the widespread use of these forms of nutrition and the consequent increase in the sophistication of the techniques, it is uncommon for deficiencies of vitamins or specific nutrients to develop. Nevertheless, it is important to be aware of the endocrinologic problems that could occur with “incomplete” nutritional support. For example, osteomalacia can develop in patients who do not receive adequate vitamin supplements, especially if they are being fed intravenously or have steatorrhea and malabsorption.85