Cases 95 : laparotomy patient with hospital-acquired pneumonia


History

On the ward round with your consultant, you see a patient on intensive care. The patient had an emergency laparotomy for faecal peritonitis 5 days previously. He underwent a Hartmann’s procedure for a perforated sigmoid diverticulitis. He is currently being ventilated and has developed a hospital-acquired pneumonia. He is likely to require ventilation on intensive care for a number of days and the staff are concerned because he has not received any nutrition since his operation.

Questions

• What are the two main methods of providing nutrition that you may consider?
• What are the routes of administration for each type?
• What are the advantages and disadvantages of each type?
• What is a Hartmann’s procedure?
• Which method of feeding would be most appropriate in this patient?


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