A double-blind clinical trial comparing the gastrointestinal side effects of two enteral feeding formulas.

Adequate enteral nutritional support is often limited by gastrointestinal (GI) side effects. In this pilot clinical trial we compared an enteral nutrition formula based on soy hydrolysate (study formula, SF) against a widely used intact casein formula (control formula, CF) for the incidence of GI side effects in a completely randomized double blind design. Twenty-three nonsurgical hospitalized patients requiring enteral nutritional support and free of GI symptoms were randomly assigned to receive either the CF or the SF for 6 days continuously. Both formulas were isotonic, low in residue, lactose free and isocaloric, but differed in the type and concentration of protein and the concentration of medium-chain triglycerides. After randomization both groups were comparable in demographic characteristics, and nutritional status, but there were more patients on antibiotics in the CF group. The amount of formula infused per day and the route of administration were equivalent. The number of bowel movements per day was 1.0 +/- 0.5 for the CF group and 0.6 +/- 0.3 for the SF group (p less than 0.05). The incidence of diarrhea was 10.8% days for the CF group and 6.2% for the SF group (p = NS). High gastric residuals occurred in 16.9% of days in the CF group and 3.3% in the SF group (p less than 0.05). Vomiting incidence was 10.8% in the CF group and 1.5% in the SF group (p less than 0.05). After adjustment for the use of antibiotics as a covariate, the differences in number of bowel movements, vomiting and incidence of high residuals became less significant (p less than 0.10).(ABSTRACT TRUNCATED AT 250 WORDS)

Enhancing enteral nutrition delivery: development of an enteral preparation facility.

As a result of prospective reimbursement, departments of clinical dietetics must define and maintain the nutrition services offered in the most cost-effective manner. The processing, preparation, and provision of quality enteral hyperalimentation to patients provide an example of a nutrition service in which cost-saving measures can be employed. Saint Vincent Charity Hospital and Health Center, Cleveland, decided to evaluate and increase the efficiency of tube-feeding preparation, delivery, inventory, and purchasing because of an increased demand for those services. The evaluation process resulted in the development of an enteral preparation facility, a specialty kitchen located within the foodservice department, specifically designed for cost-effective preparation and dispensation of all enteral formulas. The effort required physical space reallocation and personnel retraining. Implementation of the enteral preparation facility has resulted in improved quality of enteral nutrition services and has significantly aided nutrition support and cost-containment efforts at the hospital.