Which of the following is a complication of enteral nutritional support?

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Delivering nutrition via a feeding tube carries risk of aspiration, where formula or gastric contents enter the lungs. This is especially likely when airway protection is impaired, the patient is not elevated adequately (head of bed raised about 30–45 degrees), the tube is misplaced, or gastric emptying is delayed. Aspiration can cause chemical pneumonitis or bacterial pneumonia and can be life-threatening, which is why it stands out as a major complication of enteral nutrition.

Diarrhea, dehydration, and hypernatremia can occur with enteral feeding as well, but these are more common GI or metabolic side effects rather than the acute respiratory danger posed by aspiration. Diarrhea may result from osmolar load or intolerance to formula or antibiotics; dehydration and hypernatremia can occur with improper fluid balance or overly concentrated feeds, but they do not involve the direct risk to the lungs that aspiration does.