Abstract
This pilot study evaluated a high-energy, high-protein, peptide-based, (medium-chain triglycerides) MCT-containing enteral tube feed (Nutrison Peptisorb Plus HEHP®, Nutricia Ltd., Trowbridge, BA14 0XQ, UK.) containing 1.5 kcal/mL and 7.5 g protein/100 mL. Fifteen community-based, enterally tube-fed adults (42 (SD 16.3) years) received the intervention feed daily for 28 days, with gastrointestinal tolerance, compliance and nutrient intake assessed at baseline and after the intervention period. Incidence and intensity of constipation (p = 0.496), nausea (p = 1.000), abdominal pain (p = 0.366) and bloating (p = 0.250) remained statistically unchanged, yet the incidence and intensity of diarrhoea improved significantly after receiving the intervention feed (Z = −2.271, p = 0.023). Compliance with the intervention feed was significantly greater compared to the patient’s baseline regimens (99% vs. 87%, p = 0.038). Compared to baseline, use of the intervention feed enabled patients to significantly increase total energy (1676 kcal/day (SD 449) to 1884 kcal/day (SD 537), p = 0.039) and protein intake (73 g/day (SD 17) to 89 g/day (SD 23), p = 0.001), allowing patients to better achieve energy (from 88% to 99%, p = 0.038) and protein (from 101% to 121%, p < 0.001) requirements. This pilot study demonstrates that a high-energy, high-protein, peptide-based, MCT-containing enteral tube feed maintains gastrointestinal tolerance and improves compliance, energy and protein intake in complex, enterally tube-fed, community-based adult patients, though more work is recommended to confirm this.
Highlights
Enteral tube feeding is a valuable method of nutritional support to ensure safe and sufficient delivery of nutrition directly to the gastrointestinal tract
The major findings of this pilot study were reduced incidence and intensity of diarrhoea, improved compliance and increased energy and protein intake that better met energy and protein requirements following the use of a high-energy, high-protein, peptide-based, medium-chain triglycerides (MCT)-containing, multi-nutrient enteral tube feed (HEHP) in adult, enterally fed, community patients with complex conditions and impaired gastrointestinal function
The level of free amino acids between formulas varies. It remains to be fully understood which peptide blends and ranges of peptide sizes are the most advantageous for improving gastrointestinal tolerance and, while speculative, the peptide blend used in this study alongside the predominant MCT fat in the formula could explain the improvements in gastrointestinal tolerance observed here
Summary
Enteral tube feeding is a valuable method of nutritional support to ensure safe and sufficient delivery of nutrition directly to the gastrointestinal tract. Used in hospital and community settings, enteral tube feeding supports both acute and chronically ill patients where oral feeding is not possible or insufficient to meet nutritional requirements [1]. Supplementary to oral intake, to meet the entire or partial nutritional requirements of patients This is pertinent in various nutritionally vulnerable populations at risk of disease-related malnutrition where oral feeding is contraindicated and nutritional requirements are elevated (namely energy and protein) [8,9]. If improperly managed, reduced nutritional intake and absorption or increased nutritional losses can occur, causing difficulties in meeting energy and protein goals [14], which augments the risk of disease-related malnutrition
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