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Chapter 073. Enteral and Parenteral Nutrition (Part 12)

Table 73-10 Enteral Formulas Composition Characteristics Clinical Indications STANDARD ENTERAL FORMULA 1. Complete dietary products (+)a Suitable for most patients requiring tube feeding; some can be a. Caloric density 1 kcal/mL used orally b. Protein ~14% cals, caseinates, soy, lactalbumin c. CHO ~60% cals, hydrolyzed corn starch, maltodextrin, sucrose d. Fat ~30% cals, corn, soy, safflower oils e. Recommended daily intake of all minerals and vitamins in 1500 kcal/d f. Osmolality (mosmol/kg): ~300 MODIFIED ENTERAL FORMULAS 1. Caloric density 1.5–2 kcal/mL (+) Fluid-restricted patients Critically ill patients 2. a. High protein ~20–25% Impaired absorption protein (+) Immune-enhancing diets . | Chapter 073. Enteral and Parenteral Nutrition Part 12 Table 73-10 Enteral Formulas Composition Characteristics Clinical Indications STANDARD ENTERAL FORMULA 1. Complete dietary products a. Caloric density 1 kcal mL b. Protein 14 cals caseinates Suitable for most patients requiring tube feeding some can be used orally soy lactalbumin c. CHO 60 cals hydrolyzed corn starch maltodextrin sucrose d. Fat 30 cals corn soy safflower oils e. Recommended daily intake of all minerals and vitamins in 1500 kcal d f Osmolality mosmol kg 300 MODIFIED ENTERAL FORMULAS 1. Caloric density 1.5-2 kcal mL Fluid-restricted patients Critically ill patients 2. a. High protein 20-25 Impaired absorption protein Immune-enhancing diets b. Hydrolyzed protein to small peptides Liver failure patients intolerant of c. Arginine glutamine nucleotides o 3 fat d. Branched-chain amino acids aromatic amino acids e. Low protein of high biologic value 3. a. Low fat partial MCT substitution b. Fat 40 cals c. Fat from MUFA d. Fat from œ3 and œ6 linoleic acid 4. Fiber provided as soy polysaccharide 0.8 g kg protein Renal failure patient for brief periods if critically ill Fat malabsorption Pulmonary failure with CO2 retention on standard formula limited utility Improvement in glycemic index control in diabetes Improved ventilation in ARDS Improved laxation Cost inexpensive moderately expensive very expensive. Note ARDS acute respiratory distress syndrome CHO carbohydrate