ASPEN ch 11 - EN formulations Flashcards
EN labels can make ____ claims without approval of FDA
structure and function
EN practice recommendations regarding EN formula selection:
veracity dependent on vendors, clinicians/consumers responsible determine veracity of info, interpret labeling and claims with caution
most EN formulations contain _____ (CHO), polymeric uses primarily ____ solids and hydrolyzed use ____
oligo/polysacc; corn syrup; maltodextrin and hydrolyzed cornstarch
common sources of fibre in EN
guar gum, soy fibre
what do SCFAs do?
energy for colonocytes, help ^ intestinal mucosal growth, promote water/Na absorption
what does insol fibre do?
decrease transite time by increasing fecal weight
fibre may be good for ___ and should be avoided if at high risk for ___
diarrhea; bowel ischeia and severe dysmotility
most common sources of LCT in EN
corn and soybean oil
why MCT may be advantageous?
absorbed directly into portal circ and no need chylomicron form for absorption, don’t need pancreatic enzymes/bile salts for digest/absorb, cleared from blood quickly and cross mito membrane without need for carnitine
what are structured lipids?
chemical re-esterification of LCT and MCT on same glycerol backbone
most common types of intact protein in EN?
casein, soy
is N absorption > with peptide based formulations or free a.a.?
peptide based
why add glutamine/arginine?
wound and muscle repair
what is osmolality?
concentration of free particles, molecules, or ions in given solution and expressed as milliosmoles per kg water
other than _____ hyperosmolality, osmolality of EN formulation has little to do with tolerance
simple sugar related
formula tolerance/diarrhea most attributable to:
severity of illness, comorbidities, enteric pathogens, meds
most common modular?
protein
protein products evaluated based on a.a. profile and ___score
protein digestibility corrected a.a. score (PDCAAS)
benefits of a formulary?
inventory control and cost savings, simplifies product selection competency by professional staff
factors to consider when develop enteral formulary:
pt acuity, digestive/absorptive capacity, organ dysfunction, metabolic rqt of most pt, formulation components that may be contraindicated, need for fluid restrict, need for aded formulation components
example of open system method:
ready to feed
why powder formula more easy contaminate than liquid?
require more manipulation during prep
drawbacks of closed system?
greater waste, potential for misconnection errors
how to prevent misconnection?
cross-spike unique nutrition source connector and ENFit, a patient access connector developed (not allow connectivity with other therapeutic devices, has locking feature preventing disconnection)
