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Some examples of increased catabolism are multiple injury trauma, sepsis, organ failure (CHF, ARF, RF), and ventilator dependent status. It is important to assess for a history of such hyper- or altered metabolic states like Diabetes Melitus, Alcoholism, Renal Failure, and COPD.
Over feeding is associated with: immunosuppression, hyperglycemia, liver dysfunction and refeeding syndrome.
Enteral No associated immune suppression, no associated infection complications, easier to maintain electrolyte balance.
Parenteral Immune suppression (the converse is also true- malnutrition also causes immune suppression), fatty liver, potential for pneumothorax, line infections, loss of gut barrier, hyperosmolality, refeeding syndrome
Feeding tubes ? great option, if the gut works, use it...
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