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Army Capt. Julie Hess, left, and Col. Joanne Slyter, clinical dietitians at Landstuhl Regional Medical Center in Germany, examine a can of food that will be used to feed patients in the hospital’s intensive care unit.
Army Capt. Julie Hess, left, and Col. Joanne Slyter, clinical dietitians at Landstuhl Regional Medical Center in Germany, examine a can of food that will be used to feed patients in the hospital’s intensive care unit. (Steve Mraz / S&S)

LANDSTUHL, Germany — The tube gets snaked through the nose, past the stomach and all the way to the small intestines where the liquid inside the tube delivers essential calories and nutrients.

This is how the unconscious wounded “eat” during their stay at Landstuhl Regional Medical Center’s intensive care unit. It’s not exactly filet mignon or Maine lobster.

Liquid meals — similar to nutrition shakes — are pumped down the tube and into patients who can’t eat on their own. They are a key part of patients’ medical treatment and help with recovery.

Army Col. Joanne Slyter, a clinical dietitian at Landstuhl, often hears people ask why a dietitian is in the intensive care unit if a patient cannot eat.

“What people do not understand is that for trauma patients — their body being in the type of metabolic process it’s going through with the injury factor — in three to five days that starvation period is equivalent to somebody who has been on a stomach starvation diet for six months,” she said.

“You need to start getting nutrition in right away, or you’re going to see major breakdown. Within 24 hours you can start seeing paralysis of the stomach. If this happens you may have to feed the patient by an IV, which adds to further complications of possible risk of infection. You want to keep the gut functioning as much as possible.”

Bypassing the stomach offers several benefits to the patients. Less chance exists for food to get into the lungs. By going past the stomach and directly into the small intestines, the food can be given to patients prior to their surgery or their flying from Germany, Slyter said.

The meal given to the patient can be taken in by the body without the use of the stomach, said Army Capt. Julie Hess, assistant chief of medical nutrition therapy at Landstuhl.

“It’s already been broken down to simple form so that most of it can just be directly absorbed by the small intestine,” Hess said. “It doesn’t have to go through the digestive process in the stomach.”

Depending on a patient’s needs and condition, the dietitians can use a variety of formulas to meet specific requirements. Patients are fed continuously throughout their stay.

And even during the ICU patients’ short stay at Landstuhl, tube-feeding is beneficial to the recovery process.

“Their recovery rates will be faster if they get that nutrition right away,” Hess said.

“It’s not always our goal to get them the max amount of calories they can have. Honestly, we just want to get in as much as we can. Even a little bit of nutrition is better than nothing. That small amount keeping the stomach going will help them once they are able to get more food in. Their body will tolerate it better.”

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