An Issue of Gastrointestinal Endoscopy Clinics
Nutrition is no longer a soft science,as the literature is exploding with prospective randomized trials that serve to guide clinical practice. When a critically ill patient is admitted to the intensive care unit, rapid placement of a feeding tube and initiation of early enteral feeding is one of the more important therapeutic strategies capable of actually changing clinical outcome. A key role is emerging for the nutrition support endoscopist, a physician with the skills to achieve enteral access, to determine the appropriate tube and level of infusion of formula within the gastrointestinal tract, and to monitor tolerance in patients prone to ileus and pulmonary aspiration. This issue illustrates how endoscopy has revolutionized the delivery of enteral nutrition to widely disparate patient populations: establishing the means by which such nutrition support is provided while promoting safety measures to protect against potential complications.