These patients have much worse outcomes than those who receive adequate calories. There are little data to guide the choice of nutrient supplements. High-protein supplements are generally used for persons with infections. In most cases, the choice of a supplement should be based on the patient's preference. For tube feeding, the most cost-effective supplement should be used.
Food can cause a significant drop in blood pressure, which is associated with falls and syncope.
The decrease in blood pressure results from carbohydrate, which releases the vasodilatory calcitonin gene-related peptide. For long-term tube feedings, most patients prefer percutaneous enteral gastrostomy tubes to nasogastric tubes. Patients with dementia tend to pull out gastrostomy tubes less often than nasogastric tubes. All types of tube feedings carry the risk of aspiration. Recent studies have shown that long-term tube feeding is associated with multiple complications and that in many cases outcomes are no better than when tube feeding is not used.