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Nutrition in Clinical Practice
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Clinical Dilemmas

Defining and Assessing Tolerance in Enteral Nutrition

Andrew C. Bernard, MD*
Barbara Magnuson, PharmD{dagger}
Betty J. Tsuei, MD*
Marjorie Swintosky, MS, RD{dagger}
Stephen Barnes, MD*
Paul A. Kearney, MD*

* Section on Trauma and Surgical Critical Care,{dagger} Department of Surgery and the Nutrition Support Service, University of Kentucky College of Medicine, Lexington, Kentucky

Correspondence: Correspondence: Andrew C. Bernard, MD, Section on Trauma and Surgical Critical Care, Department of Surgery, University of Kentucky, C224 Division of General Surgery, 800 Rose Street, Lexington, KY 40536-0298. Electronic mail may be sent to acbern00{at}uky.edu.

Nutrition support has become widely recognized as an essential component of optimal care for acutely ill patients. Enteral nutrition is preferred over parenteral routes when possible. However, prescribed enteral nutritional regimens are sometimes met with side effects and even complications. These adverse events have been collectively termed "intolerance," and forms of intolerance occur in a spectrum from bothersome at least to life threatening when most severe. Here we discuss nutritional access and its maintenance, introduce and define intolerance, and then review the current literature with regard to principal forms of enteral nutrition intolerance.

Nutrition in Clinical Practice, Vol. 19, No. 5, 481-486 (2004)
DOI: 10.1177/0115426504019005481
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