Enteral Nutrition

Question 1

Assess patient calorie, protein and fluid needs

Answer 1

Select formula based on gut function and volume tolerance.
Normal function: can tolerate intact protein and long chain fats.
Abnormal function: unable to tolerate intact protein related to allergy or malabsorption. Unable to tolerate long chain fats related to liver/pancreatic function or malabsorption.
Volume tolerance: fluid restricted vs not

Question 2

Age based formulas

Answer 2

-Term infant formula: 0-12 months, 0.67 kcal/ml
- Pediatric formula: 1-10 years: 1 or 1.5 kcal/ml
- Adult formula: 10 years and older: 1 or 1.5 or 2 kcal fomula.

Question 3

Disease based formula:

Answer 3

• Standard cow’s milk based, lactose free, low osmolality, should be first choice.
• semi-elemental, lactose free, peptide based, contain MCT; used if fail standard formula, or have SBS or BA
• Elemental, free amino acids; use for allergies and formula intolerance.
• Specialized carbohydrate free formulas in carbohydrate malabsorption