We thank Dr Patriti and his colleagues for their interest in our article and their comments and insightful questions. It is clear, as we also stated in our article, that absorption of intraluminal nutrients increases enterocyte energy demand, putting the intestine at risk for ischemia, particularly in the presence of splanchnic hypoperfusion as often seen in the postoperative period and in sepsis. A significant mismatch of oxygen demand and supply clearly plays a role in the development of nonocclusive mesenteric ischemia, and it is conceivable that feeding-formula composition and modality of administration may increase the risk of bowel ischemia.
Melis M, Fichera A, Ferguson MK. Bowel Necrosis Associated With Early Jejunal Tube Feeding—Reply. Arch Surg. 2007;142(1):101. doi:10.1001/archsurg.142.1.101