There are various mixtures that are given to patients who are receiving nutri-
tional support therapy based on the nutrient, caloric values, and osmolality that
the patient requires. These mixtures belong to one of the following groups:- Blenderized.This consists of liquids that are individually prepared based
on the nutritional needs of the patient and can include baby food with
added liquid. - Polymeric.This is divided into two subgroups:
1.Milk-based. Powder mixed with milk or water is given in large amounts
to provide complete nutritional requirements and can be used as a nutri-
tional supplement in smaller amounts.
2.Lactose-free. Liquid is used for replacement feedings and consists of
50% carbohydrates, 15% protein, 15% fat, and 20% other nutrients in an
isotonic solution (300 to 340 mOsm/kg H 2 O). This provides 1 calorie
per milliliter of feeding. This includes Ensure, Isocal, and Osmolite. - Elemental.Also know as monomeric, this is the more expensive enteral
solution. It is useful for partial GI tract dysfunction and is available in
both liquid and powder. Elemental nutrients are rapidly absorbed in the
small intestines.
Regardless of the group, these solutions consists of- Carbohydrates in the form of dextrose, sucrose, and lactose. These are sim-
ple sugars that are absorbed quickly. Starch and dextrin are also carbohy-
drates that the solution may contain. - Protein in the form of intact proteins, hydrolyzed proteins, or free amino
acids. - Fat in the form of corn oil, soybean oil, or safflower oil.
Enteral feedings are administered as:- Bolus, 250–400 mL 4 to 6 times each day. Each bolus may take about 10
minutes to administer. The patient may experience nausea, vomiting, aspi-
ration,abdominal cramping, and diarrhea if he or she cannot tolerate the
large amount of solution given in a short timeframe. This method is if the
patient is ambulatory and relatively healthy. - Intermittent drip or infusion, 300–400 mL given 3 to 6 hours over 30–60
minutes by gravity drip or infusion pump.
(^186) CHAPTER 11 Nutritional Support Therapies