الفهرس 
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Abstract
The development of nutritional support is becoming of increased importance nowadays . The main goal is to minimize the catabolic response associated with any type of illness as those suffering from sepsis, bums, major trauma or those patients undergoing surgery.
Special nutritional management should be considered in the critically-ill patients as well as patients with vital organ failure as hepatic, renal or respiratory failure.
The critically-ill patients need a special nutritional support to :
-Correct the associated metabolic changes.
-Cope with the increased daily energy expenditure.
-Overcome the associated negative nitrogen balance.
This nutritional support if well conducted will enhance patient’s cure and improves patient’s morbidity and mortality
The type of nutritional support needed is decided according to the metabolic alterations in stress .The oral route is advised whenever possible and the patient is encouraged for early food intake, even during the early postoperative period.
However, the enteral tube feeding may be needed in certain situations to deliver the nutrients directly into the stomach or the duodenum .Longer periods of enteral feeding importance arise from the fact that gastric mucosal integrity depends mainly on the presence of nutrients in the stomach.