ABSTRACT
Patients with intestinal failure require specialized nutritional support to maintain normal nutritional status and hydration. Interventions may include diet modi—cation, oral supplementation of vitamins and minerals, enteral tube feeding, and parenteral nutrition. Enteral access device placement should be considered when the promotion of intestinal adaptation can be expected to assist in the transition from parenteral nutrition to nutritional autonomy by enteral nutrition, or when oral nutrition fails in patients who are not on parenteral nutrition. Enteral access device placement can also bene—t patients with intestinal failure who suffer from intestinal obstruction and required decompression of the gastrointestinal tract. This chapter discusses the rationale for placement of an enteral access device, provide details on appropriate patient selection, and discuss technical aspects of various devices. Although the literature concerning the use of enteral feeding tubes and techniques among patients with intestinal failure is sparse, the physiologic principles concerning access to the gastrointestinal tract is generally similar for patients with and without intestinal failure.
