Skip to main content
SpringerLink
Log in

Indications for tube feedings in elderly patients

  • Published:
Dysphagia Aims and scope Submit manuscript

Abstract

Tube feedings are utilized in elderly patients with acute and chronic problems. Inadequate oral intake with malnutrition, comatose state, neurologic disorders with severe dysphagia, extensive burns, massive gastrointestinal resection, and oropharyngeal and upper gastrointestinal malignancies are the commonly encountered conditions requiring tube alimentation. Dysphagia with frequent aspiration is the most common indication for use of tube feedings in the elderly. Nasogastric tube is preferred for short-term feeding, while gastrostomy or jejunostomy is indicated for long-term or permanent nutritional support. Nutritional assessment should be done initially and on a regular basis. Specific formulas are available to calculate height, weight, and caloric needs of bedbound elderly patients. Various enteral feeding formulas are available for a specific clinical condition and are preferably administered by continuous drip using a pump. Parenteral nutrition is also indicated for certain situations in which enteral feeding cannot meet the patient's nutritional requirement, and in particular situations where enteral feeding is contraindicated and not feasible. Optimal patient care is dependent on adequate nutritional support.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Schwartz DB: Enteral therapy. In Rombeau JL, Caldwell MD (eds):Enteral and Tube Feeding, vol 1. Philadelphia: WB Saunders, 1984, pp 93–111

    Google Scholar 

  2. A.S.P.E.N. Board of Directors: Guidelines for the use of enteral nutrition in the adult patient.J Parenteral Enteral Nutr 11:435–439, 1987

    Google Scholar 

  3. Newmark SR, Simpson MS, Beaskitt MP, et al: Home tube feeding for long term nutritional support.J Parenteral Enteral Nutr 5:76–79, 1981

    CAS  Google Scholar 

  4. Heymsfield SB, Bethel RA, Ansley JD, et al: Enteral hyperalimentation: an alternative to central venous hyperalimentation.Ann Intern Med 90:63–71, 1979

    CAS  PubMed  Google Scholar 

  5. Ciocon JO, Silverstone FA, Graver LM, Foley CJ: Tube feedings in elderly patients.Arch Intern Med 148:429–433, 1988

    Article  CAS  PubMed  Google Scholar 

  6. Rombeau JL, Jacobs DO: Nasoenteric tube feeding. In Rombeau JL, Caldwell MD (eds):Enteral and Tube Feeding, vol 1. Philadelphia: WB Saunders, 1984, pp 261–274

    Google Scholar 

  7. Greenberg RE, Holt PR: Presbyesophagus and disorders of the esophagus in the elderly.Gastroenterology 5:56–75, 1984

    Google Scholar 

  8. Pareira MD, Conrad EJ, Hicks W: Therapeutic nutrition with tube feeding.JAMA 156:810–816, 1954

    CAS  Google Scholar 

  9. Ponsky IL, Gauderer MWL, Stellato TA: Percutaneous endoscopic gastrostomy: review of 150 cases.Arch Surg 118:913–914, 1983

    CAS  PubMed  Google Scholar 

  10. Moore JP, Curreri PW, Rodning CB: Percutaneous endoscopic gastrostomy.Am Surg 52:495–499, 1986

    CAS  PubMed  Google Scholar 

  11. Foutch PG: Percutaneous endoscopic gastrostomy: a new procedure comes of age.J Clin Gastroenterol 8:10–15, 1986

    CAS  PubMed  Google Scholar 

  12. King TC, Ramos AG, Zimmerman JM: The feeding gastrostomy: friend or foe.Am J Surg 109:450–452, 1965

    CAS  PubMed  Google Scholar 

  13. Russell TR, Brotman M, Norris F: Percutaneous gastrostomy: a new simplified and cost-effective technique.Am J Surg 148:133–137, 1984

    Article  Google Scholar 

  14. Pomerantz MH, Salomon J, Dunn R: Permanent gastrostomy as a solution to some nutritional problems in the elderly.J Am Geriatr Soc 28:104–107, 1980

    CAS  PubMed  Google Scholar 

  15. Chung RS: Enteral nutrition by percutaneous endoscopic gastrostomy and jejunostomy: techniques and results.Nutr Int 3:110–115, 1987

    Google Scholar 

  16. Moore EE, Dunn EL, Jones TN: Immediate jejunostomy feeding.Arch Surg 116:681–684, 1981

    CAS  PubMed  Google Scholar 

  17. Baker JP, Detsky AS, Wesson DE, et al: Nutritional assessment: a comparison of clinical judgement and objective measurements.N Engl J Med 306:969–972, 1982

    Article  CAS  PubMed  Google Scholar 

  18. Detsky AS, Baker JP, Mendelson RA, et al: Evaluating the accuracy of nutritional assessment techniques applied to hospitalized patients: methodology and comparisons.J Parenteral Enteral Nutr 8:153–159, 1984

    CAS  Google Scholar 

  19. Mitchell CO, Lipschitz DA: The effect of age and sex on the routinely used measurements to assess the nutritional status of hospitalized patients.Am J Clin Nutr 36:340–349, 1982

    CAS  PubMed  Google Scholar 

  20. Mitchell CO, Lipschitz DA: Detection of protein calorie malnutrition in the elderly.Am J Clin Nutr 35:398–406, 1982

    CAS  PubMed  Google Scholar 

  21. Kane RL, Ouslander JE, Abrass IB:Essentials of Clinical geriatrics, 2nd ed. New York: McGraw-Hill, 1989, pp 288–290

    Google Scholar 

  22. Chumlea WC, Roche AF, Steinbaugh ML: Estimating stature from knee height for persons 60 to 90 years of age.J Am Geriatr Soc 33:116–120, 1985

    CAS  PubMed  Google Scholar 

  23. Steinbaugh ML, Chumlea WC, Guo S, Roche AF: Estimating body weight for the nonambulatory elderly, abstracted. American Dietetic Association 69th Annual meeting, Las Vegas, October 27–31, 1986

  24. Winograd Carol H: Malnutrition. In Ham RT (ed):Geriatrics medicine annual. New Jersey: Medical Economics Books, 1987, pp 183–186

    Google Scholar 

  25. Munro HN: Nutritional requirements in health.Crit Care Med 8:2, 1980

    CAS  PubMed  Google Scholar 

  26. Bury KD, Jambanathan G: Effects of elemental dicts on gastric emptying and gastric secretion in man.Am J Surg 127:59–64, 1974

    Article  CAS  PubMed  Google Scholar 

  27. Hiebert JM, Brown A, Anderson RG, et al: Comparison of continuous versus intermittent tube feedings in adult burn patients.J Parenteral Enteral Nutr 5:73–75, 1981

    CAS  Google Scholar 

  28. Dobbie RP, Hoffmeister JA: Continuous pump-tube enteric hyperalimentation.Surg Gynecol Obstet 143:273–276, 1976

    CAS  PubMed  Google Scholar 

  29. Woolfson AMJ, Ricketts CR, Hardy SM, et al: Prolonged nasogastric feedings in critically ill and surgical patients.Postgard Med J 52:678–681, 1976

    CAS  Google Scholar 

  30. Kirby DF, Craig RM, Tsang T, Plotnick BH: Percutaneous endoscopic gastrostomies: a prospective evaluation and review of literature.J Parenteral Enteral Nutr 10:155–159, 1986

    Article  CAS  Google Scholar 

  31. Alberti-Flor JL, Wright G, Arevalo P, Vaughan S, Dunn GD: Percutaneous endoscopic placement of large gastrostomy feeding tubes.Am J Gastroenterol 81:222–223, 1986

    CAS  PubMed  Google Scholar 

  32. Robinson G, Goldstein M, Levine GM: Impact of nutritional status on DRG-length of stay.J Parenteral Enteral Nutr 11:49–51, 1987

    CAS  Google Scholar 

  33. Mullen JL, Gertner MH, Buzby GP, et al: Implications of malnutrition in the surgical patient.Arch Surg 114:121–125, 1979

    CAS  PubMed  Google Scholar 

  34. Feitelson M, Bernstein LH, Pleban WE: Tube feeding utilization: a quality of care review.J Am Diet Assoc 87:73–74, 1987

    CAS  PubMed  Google Scholar 

  35. Mullen JL, Buzby GP, Matthews DC, et al: Reduction of operative morbidity and mortality by combined preoperative and postoperative nutritional support.Ann Surg 192:604–606, 1980

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Man Appalachian Regional Healthcare, 700 East McDonald Avenue, 25635, Man, WV, USA

    Jerry O. Ciocon MD

Authors
  1. Jerry O. Ciocon MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ciocon, J.O. Indications for tube feedings in elderly patients. Dysphagia 5, 1–5 (1990). https://doi.org/10.1007/BF02407387

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02407387

Key words

Search

Navigation