enteral formula

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Introduction

Standard enteral formula

Modified enteral formulas

caloric density
- 1.5-2 kcal/mL; fluid restricted patients
protein modified
- high protein, 20% of calories (Promote)
  - protein malnutrition & poor wound healing
- hydrolyzed protein to small peptides (Peptamen)
  - decreased protein digestion or absorption or allergy
- increased glutamine, arginine, S-amino acids, nucleotides
  - severely immunocompromised patients
- increased branched-chain amino acids with decreased aromatic amino acids
  - liver failure
- decreased protein, K+, Mg+2 & phosphorous (Suplena)
  - renal failure
- decreased protein with increased essential amino acids & decreased vitamins & minerals
  - renal failure patient NOT on dialysis
fat modified
- low fat, partial MCT* substitution
  - fat malabsorption
- increased fat 40% of calories
  - pulmonary failure with increased pCO2 on standard formulas
- increased fat from MUFA*
  - poorly controlled diabetes mellitus
- fat increased in omega-3 fatty acids (fish oil) & decreased in omega-6 fatty acids
  - immunocompromised patients or autoimmunity
fiber modified (Jevity)
- fiber as soy polysaccharide
  - diarrhea or constipation
- fiber provides as blenderized fruits & vegetables
  - minimize binding of dilantin
vitamin & mineral modified
- increased minerals (Zn+2) & vitamin A & vitamin C)
  - decubitus ulcers

↑ Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 479