Dispelling Myths and Unfounded Practices About Enteral Nutrition

Zoeller, Stephanie; Bechtold, Matthew L.; Burns, Berri; Cattell, Theresa; Grenda, Brandee; Haffke, Lindsey; Larimer, Cara; Powers, Jan; Reuning, Fred; Tweel, Lauren; Guenter, Peggi

doi:10.1002/ncp.10456

Cited by 2 publications

(4 citation statements)

References 37 publications

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“…Commercial and homemade BTF formulas generally lack palatability, if undiluted require 12 or 14 Fr or large‐diameter enteral access devices, and are viscous 25,29–31 . Commercially available BTF formula ranges from a mixture of blended foods and formulas to products which are entirely food‐based.…”

Section: Elemental Formulasmentioning

confidence: 99%

“…28 Commercial and homemade BTF formulas generally lack palatability, if undiluted require 12 or 14 Fr or largediameter enteral access devices, and are viscous. 25,[29][30][31] Commercially available BTF formula ranges from a mixture of blended foods and formulas to products which are entirely food-based. BTF formulas are distinct from standard or hydrolyzed formulas that are made entirely from plants, as the latter are not produced in a blenderized manner.…”

Section: Elemental Formulasmentioning

confidence: 99%

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Pediatric formulas: Categories, composition, and considerations

et al. 2023

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Formulas, liquid nutrition, may be consumed orally or via a feeding tube to provide partial or complete nutrition that a given individual could not obtain using natural food stuffs in their native form. A wide range of commercially available formulas exist, which may be used as sole-source nutrition or in conjunction with other foods. Physicians and dietitians must understand the nature of and indications for specific formulas to treat diseases, provide complete nutrition to patients, and avoid harm. Products vary in macronutrient and micronutrient content and calorie concentration among many other factors. They are formulated specifically for patients of specific ages, correlating to nutritional needs and medical diagnoses. Additionally, formula availability, insurance coverage, mode of consumption, physiologic tolerance, and caregiver preference influence formula selection. Caregivers may also make their own pediatric formulas. We review commercial and homemade pediatric formulas.

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Section: Elemental Formulasmentioning

confidence: 99%

Section: Elemental Formulasmentioning

confidence: 99%

Pediatric formulas: Categories, composition, and considerations

et al. 2023

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“…Current guidelines from the American Society of Parenteral and Enteral Nutrition provide recommendations for well tolerated delivery of medications through EADs and include not adding medications directly to nutrition formula, administering each medication separately, using available liquid formulations if compatible with EADs, appropriately preparing immediate-release solid dosage forms, only using clean enteral syringes for administration, appropriately irrigating the EAD around drug administration and holding enteral nutrition when indicated [15]. For every drug administered, the EAD should be flushed with at least 15 ml of sterile water before administration and at least 15 ml after the final administration and each medication should be diluted in at least 5 ml of sterile water, although frequently 30–60 ml is required for powdered medications [9,15,16 ▪ ]. It should be noted that very few medications require enteral nutrition to be held.…”

Section: Effect Of Osmolalitymentioning

confidence: 99%

“…It should be noted that very few medications require enteral nutrition to be held. In fact, nutritional interruptions occur 12.8% of the time and can result in energy and protein deficiencies so every effort should be made to continue enteral nutrition when administering medications through EADs [16 ▪ ]. Cyclic or bolus feeding may help circumvent the need to temporally interrupt feeding.…”

Section: Effect Of Osmolalitymentioning

confidence: 99%

Considerations when administering medications enterally in the critically ill

MacLaren

2023

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of reviewEnteral administration of medications to critically ill patients may be advantageous to other routes of administration. This review summarizes key considerations for the bedside clinician when medications are administered through enteral access devices (EADs).Recent findingsCritical illness is associated with gastrointestinal dysfunction that inconsistently affects drug dispersion and absorption and may enhance or reduce bioavailability. Other factors such as the first-pass metabolism, microbiome alterations and the concomitant use of other medications (vasopressors, acid suppressants) may influence drug absorption. Concurrent administration of medications with enteral nutrition is fraught with potential errors. Drug-nutrient and drug-drug interactions may lead to tube occlusion. Although liquid formulations of medications are preferred over solid dosage forms for EAD administration, they may be hyperosmotic or contain sorbitol to cause gastrointestinal disturbances. The size and placement of the EAD tube may influence drug dispersion and absorption to affect the pharmacokinetic profile and efficacy of a particular drug.SummaryThe therapeutic effect may be diminished, or toxicity enhanced when medications are administered through EADs in the critically ill. The bedside clinician must be aware of factors impacting the bioavailability of enterally administered medications and be cognizant that the effect will differ by medication.

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Dispelling Myths and Unfounded Practices About Enteral Nutrition

Cited by 2 publications

References 37 publications

Pediatric formulas: Categories, composition, and considerations

Pediatric formulas: Categories, composition, and considerations

Considerations when administering medications enterally in the critically ill

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