There are a number of contraindications to enteral nutrition. Some relate to the route of access, while others relate to permanent or temporary conditions.
Contraindications to enteral nutrition include:
(1) generalized peritonitis
(2) bowel obstruction
(3) surgical discontinuity of the intestines
(4) paralytic ileus
(5) known or suspected bowel or mesenteric ischemia
(6) uncontrolled gastrointestinal bleeding
(7) high-output fistula without distal feeding access
(8) abdominal compartment syndrome
(9) hypothermia with body temperature < 35.5°C
(10) high risk for non-occlusive bowel ischemia (uncontrolled shock, uncontrolled hypoxemia, severe hypercapnea)
(11) gastric aspirate > 500 mL in 6 hours
(12) intractable nausea and vomiting
(13) pneumatosis intestinalis
Cause for concern for nasogastric or orogastric feeding:
(1) high gastric residuals
(2) risk for aspiration pneumonia
(3) severe oral mucositis
