Osmolality and pH in handmade enteral diets used in domiciliary enteral nutritional therapy

Patients who need prolonged domiciliary enteral nutritional therapy may benefit from handmade diets. However, the preparation of such diets might cause insecurity with regard to their nutritional composition and physical-chemical properties. Current study analyzes the osmolality and Hydrogen-Ion concentration (pH) on handmade enteral diets. To this purpose, six formulas and two juices, prescribed on discharge from hospital, were analyzed physically and chemically. Osmolality and pH were respectively determined by cryoscopy and potentiometry. Most formulations were classified as isosmolar (with less than 400 mOsm/kg solvent), and only one was classified as slightly hyperosmolar, with rates ranging from 356.7 to 403.5 mOsm/kg solvent. On average, the standard formula presented higher osmolality than similar ones prepared for hyperglycemia. Among the juices, only one registered hyperosmolar concentration of 595.54 mOsm/kg solvent. All formulas presented pH rates classified as low acidity, ranging between 6.1 and 6.6, while the two juices had the lowest results, 4.73 and 4.66 each. The blend of ingredients used in handmade formulas and juices studied presented acceptable osmolality and pH rates for a safe administration and absence of gastrointestinal complications. Data showed here are consistent with an appropriate and healthy diet and contributed towards success in domiciliary enteral nutritional therapy.

Análise da variação do pH de três pastas à base de hidróxido de cálcio, quando associadas ao PMCC, clorexidina e aloe vera / Analysis of the pH variation of three calcium hydroxide-based pastes, when associated with CMCP, chlorhexidine and aloe vera

O objetivo deste estudo, in vitro, foi analisar a variação do pH de três pastas à base de Ca(OH)2 e de cada um de seus componentes. Foram formados quatro grupos teste: GI: Ca(OH)2 + propilenoglicol (PG) + Aloe vera; GII: Ca(OH)2 + PG + paramonoclorofenol canforado (PMCC); GIII: Ca(OH)2 + PG + clorexidina 2% e grupo controle (água destilada). As pastas foram depositadas em frascos contendo 15 ml de água destilada e estes armazenados em estufa a 37° C. A mensuração do pH foi realizada em 7 intervalos de tempo. Os grupos testados apresentaram crescimento exponencial dos valores de pH registrados até 24 h e estabilização em 14 dias. Os controles apresentaram valores de pH inferiores em relação aos demais grupos (p<0,05 ­ ANOVA). A partir de t = 24 h, GII e GIII apresentaram maiores valores de pH em relação a GI (p<0,05 ­ Bonferroni). Numa segunda etapa, foram formados cinco grupos com os componentes individuais de cada pasta: GIc ­ clorexidina líquida 2%; GIIc ­ PG; GIIIc ­ PMCC; GIVc ­ hidróxido de cálcio P.A.; GVc ­ Aloe vera. GIVc e GVc apresentaram, respectivamente, os maiores e menores valores de pH registrados até o final do experimento (12,63 e 5,54). Conclui-se que o pH das pastas de Ca(OH)2 pode variar em função da sua composição, porém sempre se mantendo alcalino, mesmo quando associada à Aloe vera, cujo pH ácido foi registrado no presente estudo. No entanto, uma maior alcalinidade foi apresentada pelas pastas contendo clorexidina ou PMCC em sua composição.

The objective of this study, in vitro, was to analyze the variation of the pH of threeCa(OH)2 - based pastes and each of its components. There were four groups test: GI: Ca(OH)2 + propylene glycol (PG) + Aloe vera; GII: Ca(OH)2 + PG + camphorated paramonochlorophenol (CMCP); GIII: Ca(OH)2 + PG + 2% chlorhexidine and control group (distilled water). The pastes were deposited in vials containing 15 ml of distilled water and stored in a 37° C incubator. The measurement of pH was performed in 7 time intervals.The groups tested showed exponential growth of pH values recorded up to 24 h and stabilization in 14 days. The controls showed pH values lower than the other groups (p<0.05 ­ ANOVA). From t = 24 h, GII and GIII had higher levels of pH compared to GI (p<0.05 - Bonferroni). Subsequently, five groups were formed with the individual components of each paste: GIc - 2% chlorhexidine liquid; GIIc - PG; GIIIc - CMCP; GIVc - calcium hydroxide; GVc - Aloe vera. GIVc and GVc showed, respectively, the highest and lowest pH values recorded by the end of the experiment (12.63 and 5.54). It was concluded that the pH of Ca(OH)2 pastes may change depending on their composition, but always remained alkaline, even when associated with Aloe vera, whose acidic pH was recorded in this study. However, a higher alkalinity was presented by pastes containing chlorhexidine or CMCP in its composition.