Enteral Nutrition with Isocal

ABSTRACT

To evaluate the effect and untoward reaction of "Isocal(Mead-Johnson B.V., Netherlands), lactose free polymeric enteral nutrient, 32 surgical or malnourished patients were selected. The nutritional parameters and indices after feeding of Isocal were compared to the pretreatment states. Routes of intake were oral(N=17) or nasoduodenal tube feeding(N=15). The average duration of treatment were 14.3 days(8 to 30 days). Among the 6 trial failures, 4 cases were directly related with Isocal feeding, such as intolerable diarrhea(N=3), and abdominal pain with partial ileus of recurrent stomach cancer(N=1). Transient diarrheas were in 3 cases. All of the cases with diarrhea were in oral feeding group. Nutritional parameters such as anthropometric scales and serum albumin showed progressive improving tendencies after Isocal, and transferrin(p=0.017) and total lymphocyte counts(TLC, p=0.057) in transitional feeding group revealed significant improvements. Nitrogen balance improved within the first week(p=0.000) of feeding. The Instant Nutritional Score(INS) of 9 cases got better, but 3 became worse, which includes 2 cases of terminal recurrent cancers. CPK revealed a significant drop(p=0.021) in one week. Blood chemical parameters didn't show any untoward changes during the periods. In conclusion, Isocal, via oral as well as nasoduodenal tube feeding, was an effective and useful enteral nutrient with acceptable side effects. Nasoduodenal tube feeding was preferable to avoid unwanted diarrhea. Transferrin, TLC, nitrogen balance, INS and CPK were reliable nutritional parameters even in two weeks' short period of clinical study.