Osmolality of Modified Enteral Tube Feeds for Adults in Hospitals Across the Western Cape Province

ABSTRACT

Objectives: The first aim of this study was to determine the incidence of use; reasons for use; and procedures/recipes followed in modifying enteral tube feeds (ETFs) for adults in state and private hospitals across the Western Cape Province (WCP); South Africa (baseline data). The second aim was to determine the osmolality of the modified ETFs used by these hospitals (osmolality data). Design: A descriptive cross-sectional study. Setting and subjects: The study was conducted in January/February 2007. The baseline data was collected by means of a coded questionnaire sent to all state and private hospitals in the WCP (n = 111); excluding all children's hospitals. The osmolality data was obtained by means of freeze-point depression of the modified ETF recipes obtained from the participating hospitals. Results: A total response rate of 94was obtained. Of the participating hospitals (n = 104); 48were state (n = 50) and 52were private hospitals (n = 54). Sixty-two per cent of hospitals (n = 64) made use of ETFs; with 25modifying their feeds (n = 16). Twelve recipes were obtained for the osmolality testing. Eight recipes (66) were significantly lower (p 0.001); two (16) were significantly higher (p 0.001) and two of the recipes did not differ from the standard enteral product. Eight recipes (66) had a significantly higher average osmolality (p 0.001) than that of body fluid. The concentrated ETF recipe (1.43 kcal/ml) had the highest osmolality (707 mOsm/kg/H20). Conclusions: Modular ETFs had lower average osmolality than those of the semi-modular and the standard enteral products; and of body fluid (300 mOsm/kg/H20)