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TUBE FEEDING FORMULAS
I.
BASIC POLYMERIC FORMULAS: Consist of intact proteins, 1-1.06 kcals/cc
A. Osmolite: lower in protein (37 grams/L)
B. OsmoliteHN: moderate protein (44 grams/L)
C. Jevity: same protein + kcal content as OsmoHN, but with 14.4g fiber/L
D. Promote: high in protein (62.5 grams/L)
II.
CONCENTRATED POLYMERIC FORMULAS: 2 kcals/cc
A. TwoCalHN: ratio of calories:protein similar to OsmoHN; higher in fat
B. Nepro: see disease specific below
III.
DISEASE SPECIFIC/SPECIALTY FORMULAS
A. Renal: all are 2 kcals/kg, as well as being lower in K+, Phos, and Na+
i.
Nepro: 70 grams protein/L
ii.
Renalcal: 34.4 grams protein/L, K+, Phos and Na+ free
iii.
Suplena: 30 grams protein/L
B. Hepatic
i.
Nutrihep: moderately concentrated at 1.5 kcals/cc; 50% of total
protein comprised of BCAA
C. Pulmonary
i.
Pulmocare or Oxepa: 1.5 kcals/cc; moderate protein (41 grams/cc),
higher fat and lower CHO
D. Lipid Malabsorption
i.
Lipisorb liquid: 1.35 kcals/cc; 57grams protein/L, 85%of fat as MCT
(medium chain triglycerides do not require bile acids or enzymatic
breakdown)
E. Immune Enhancing
i.
Impact: 3 patented ingredient are Arginine, omega-3 fatty acids, and
dietary nucleotides. 1 kcal/cc, 56 grams protein/L.
• Arginine: conditionally essential amino acid key for wound healing,
nitrogen retention, needed for T cell growth and replication.
• Omega-3 fatty acids: Inhibit inflammatory effects of Omega-6 fatty
acids
• Nucleotides: During stress dietary source needed. Promotes T cell
production and replication.
• Protocol for use needs to be changed based on new evidence that it
may be harmful in the most critically ill patients (increased mortality
in this group)
• Three times the cost of basic polymeric formulas
IV.
SEMI-ELEMENTAL FORMULAS
A. Peptamen VHP: enzymatically hydrolyzed protein, 70% MCT oil, 1kcal/cc,
62.5 grams protein /L
*Note: Alitraq and Vital HN will no longer be on the formulary
V.
MODULES
A. Protein:
i.
Promod- to be replaced by BeneProtein: 6 grams protein and 25
kcals per scoop. Used frequently for patients on propofol to meet
protein requirements.
B. Fat:
i.
MCT Oil: 8 kcals/cc, 933 grams fat/L
ii.
Microlipid: 4.5 kcals/cc, 500 grams fat/L; Safflower oil
C. Carbohydrate + Fat:
i. Duocal: 42 kcals per Tbsp., 6.2 grams CHO/Tbsp., 1.9 grams fat/Tbsp.
(35% MCT oil)