Editing Artificial nutrition (section)

=== '''Post-op''' ===

** '''Indications'''
*** Anastomotic leak
*** Gastrointestinal fistula
*** SBO/ileus
*** Post-op delayed gastric emptying
*** Chyle leak
*** Inadequate absorptive capacity
*** Feeding tube complications
*** Pre-existing malnutrition
** '''Absolute contraindications'''
*** Able to receive enteral feeding
*** Anticipated duration of fasting less than 5 days
*** Terminal illness with short life expectancy
*** Refusal/advance directive
** '''Relative contraindications'''
*** Shock - can worsen their condition
*** Catheter-related infection
*** Acid-base disturbance
*** Severe electrolyte disturbance
*** Refeeding syndrome
*** Volume overload
*** Lack of central venous access
** '''Timing'''
*** Risks outweigh benefits for first five days post-op in most patients
*** Can start earlier than five days in patients with chronic malnutrition and anticipated prolonged fasting
*** Should certainly be given at 14 days of starvation in otherwise healthy patients