What is and how to in safe early enteral feeding Tzu-Ming Chang MD. Professor of Surgery, Taichung MetroHarbor Hospital, Taipei Nutritional support is a vital part of the therapy of most hospitalized patients. Early initiation, particularly via the enteral route, has a significant effect on disease progress in a wild variety of patients. Early enteral nutrient administration has a significant impact on preserving gastrointestinal integrity and barrier function and maintaining intestinal immunologic defenses, which may have a role in decreasing infectious outcomes in critically patients. Although the benefits of early nutritional support have been demonstrated at cellular and tissue level and in animal studies of critical illness, the effect on patient morbidity and mortality has been less clear. The mechanisms for the benefit of early nutrition have not been fully elucidated. Reduction of hyper metabolism and increased gut blood flow may a key role in early enteral feeding. Futhermore, in may also effects intestinal permeability and decreased in inflammatory cytokines production which may caused the development of multiple organ failure after multiple injury. The Question "How early is early" is important, since maintaince of early feeding requires time, patience, and dedication. It appears with in 24 hr with in 48 hr is acceptable. However, despite this important theoretical dilemma, the question should perhaps no longer be "Why early gut feeding?" but rather, "Why not?". Although labor intensive, the provision of early feeding, particularly via the enteral route is a worth while good for all clinicians. From "The 10th Congress of PENSA" Dusit Resort Pattaya, Chonburi, Thailand, October 27--29, 2004 Page : 55