EPS05.2 Novel point of care immobilized lipase device (EFIC™) is compatible with a range of nutritional formulas and can simplify delivery of hydrolyzed fat during tube feeding

Abstract

Objectives Enteral feeding is widely used to improve nutritional status in people with developmental immaturity or exocrine pancreatic insufficiency (EPI) including CF. While all fats provide caloric benefit, long-chain polyunsaturated fatty acids (LCPUFA) are also structural components of membranes and biological mediators involved in the regulation of many physiological functions. However use of PERTs is ineffective with liquid formula in particular LCPUFA digestion. Alcresta has developed the Enteral Feeding In-Line Cartridge (EFIC), a single-use point-of-care device containing immobilized lipase. A microbial lipase was selected based on its ability to hydrolyze LCPUFAs since these are the most complex fats to digest and the fatty acids most deficient in EPI. Enteral formula passes through the EFIC ex-vivo resulting in rapid hydrolysis of fats into readily absorbable fatty acids and monoglycerides. Methods A colorimetric assay (detection: C8 to C20) was used to measure fatty acid release resulting from the action of the EFIC. A range of commercially available enteral formulas was tested. The EFIC device was evaluated in terms of the percent of hydrolyzed fat delivered over the length of the feeding. Results Overall, for most commercial formulas the EFIC hydrolyzes ∼90% of fat, in particular physiologically relevant LCPUFA such as DHA, EPA and AA while leaving other nutritional components and flow rate unaffected. Conclusion This novel EFIC device consistently optimizes delivery of readily absorbable fats to patients with compromised pancreatic function using enteral feeding (e.g. premature infants, cystic fibrosis or oncology).