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Information from Your Family Doctor
Artificial Fluids and Nutrition
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Am Fam Physician. 2000 Oct 1;62(7):1562-1563.
See related article on life-sustaining treatment.
When do people need artificial fluids and nutrition?
If a patient isn't able to swallow because of a temporary medical problem, artificial feeding and fluids can be given until they recover.
Artificial feeding and fluids are options for a patient who has an advanced, life-threatening illness and is dying. The patient, family members and doctor can talk about these options and the benefits and risks.
What is involved in artificial feeding?
An intravenous 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 fluids and feeding 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 one to four weeks. If the feeding 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).
What happens if artificial fluids or nutrition are not given?
Persons who don't receive any food or fluids because of illness will eventually fall into a deep sleep and usually die in one to three weeks.
What are the benefits?
A person with a temporary illness who can't swallow may feel hungry or thirsty. A feeding tube may help these symptoms. 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 may lessen the confusion.
For a patient with an advanced life-threatening illness who is dying, there may not be many benefits. This is a time when the patient, family members and doctor can talk about the best option. Artificial fluids and feeding in these patients may make the patient live a little longer, but not always.
What are the burdens?
There's always a risk to a patient being fed through a feeding 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.
Information in this handout is from Education for Physicians on End-of-Life Care Trainer's Guide, Module 11, withholding, withdrawing therapy. In: Emanuel LL, von Gunten CJ, Ferris FD. Education for physicians on end-of-life care/Institute for Ethics at the American Medical Association. Chicago, IL: EPEC Project, The Robert Wood Johnson Foundation, 1999.
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
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