Nutritional Support

Introduction
When do people need artificial hydration and nutrition?
What is involved in artificial nutrition and hydration?
What happens if artificial hydration or nutrition are not given?
What are the benefits?
What are the risks?
How do we decide whether to use artificial hydration and nutrition?

Artificial nutrition support and hydration is a medical treatment that allows a person to receive nutrition (food) and hydration (fluids) when they are no longer able to take them by mouth. Artificial nutrition and hydration is given to a person who for some reason cannot eat or drink enough to sustain life or health. Doctors can provide nutrition and hydration through intravenous (IV) administration or by putting a tube in the stomach.

If a patient isn't able to swallow because of a medical problem, he or she can be given fluids and nutrition in ways other than by mouth. This is referred to as artificial hydration and nutrition. This is sometimes done when someone is recovering from a temporary problem. It may also be done when someone has an advanced, life-threatening illness and is dying.

An intravenous (IV) catheter (a thin plastic tube that slides in over a needle) may be placed in the vein under the patient's skin. Fluids and sometimes nutrition are given through the catheter. Another method of artificial nutrition and hydration is through a plastic tube called a nasogastric tube (also called an NG tube). This tube is put through the nose, down the throat and into the stomach. It can only be left in for a short time, usually 1 to 4 weeks. If the tube has to be in longer, a different kind of feeding tube may be used. It's placed into the wall of the stomach (also called a PEG tube or g-tube).

Persons who don't receive any food or fluids will eventually fall into a deep sleep (coma) and usually die in 1 to 3 weeks.

A person with a temporary illness who can't swallow may be hungry and thirsty. A feeding tube may help. Sometimes a person may become confused because of dehydration. Dehydration is when the body doesn't get enough fluids. Giving a patient fluids through a tube help dehydration and may lessen his or her confusion. Giving fluids and nutrition helps the patient as he or she is recovering.

For a patient with an advanced life-threatening illness who is dying, artificial hydration and nutrition may not provide many benefits. Artificial hydration and nutrition in these patients may make the patient live a little longer, but not always.

There's always a risk when someone is fed through a tube. Liquid might enter the lungs. This can cause coughing and pneumonia. Feeding tubes may feel uncomfortable. They can become plugged up, causing pain, nausea and vomiting. Feeding tubes may also cause infections. Sometimes, patients may need to be physically restrained or sedated to keep them from pulling out the feeding tube.

The patient and his or her family should talk with the doctor about the patient's medical condition and risks and benefits of giving artificial hydration and nutrition. Each situation is different. Your doctor can help you make the decision that is right for the patient and family.