ABSTRACT

Enteral nutrition (EN) provides energy and hydration to promote growth and development in infants and children when their oral intake is insufficient, unsafe, or compromised. To supply the necessary nutrients and fluids through the digestive tract in this subset of patients, an enteral access device (EAD) is required. A variety of EADs can be placed through the nares, mouth, stomach, or small intestine to provide nutrition, fluids, and medications directly to the gastrointestinal tract. The EAD should be thoughtfully selected and cared for to avert patient discomfort, mechanical device-related complications, and interruptions in the delivery of nutrients, hydration, and medications. When nutrition and hydration through the digestive system is not possible, parenteral nutrition (PN) is lifesaving. To provide PN support effectively and safely, a judiciously selected central venous catheter is required, along with appropriate care and monitoring. This chapter discusses EADs and parenteral vascular access devices, along with clinical indications, advantages, and disadvantages of each with recommendations for prevention of complications and troubleshooting of potential problems.