ppt课件-enteralnutrition-universityofakron.pptVIP

ENTERAL NUTRITION MEETING NUTRIENT NEEDS Selection of Feeding Route Page 536, Krause – Figure 23-1 Algorithm or Decision Tree Adequate oral intake Oral intake + supplements Enteral nutrition support Patient’s medical status Anticipated duration of tube feeding Risk for aspiration Advantages and disadvantages of access route Enteral Formula Selection Selection Algorithm: Page 538, Krause – Figure 23-3 Feed as close to the farm as possible: e.g. the most intact formula the patient will tolerate Intact nutrient, general purpose formulas are the least expensive and may be more physiological Enteral Formulary What products are available? More cost effective to have formulary Include multiple products, one main brand of each category Where can you get information about enteral products? Nutrition Care Manual formulary page /universi13 Novartis Nutrition USA/us/home Abbot Nutrition Product Handbook /productHandbook/default.aspNestle Nutrition / Nutrition Care Manual Formulary You can View compositional information about adult and pediatric formulas Calculate nutrient delivery based on volume Compare two formulas in the same category BUT: be aware that the most reliable and up to date source of information about a formula is from the mfr. Enteral Selection Blenderized Compleat or homemade (CAUTION!) Standard Isotonic Osmolite, Nutren, Isosource Added fiber Jevity, Impact with Fiber, Nutren with Fiber, Nutren Replete with Fiber, Nutren 1.5 Fiber, Fibersource, Fibersource HN, Enteral Selection Extra calories/volume restricted Osmolite 1.2, TwoCal HN, Novasource 2.0, Nutren 1.5, Nutren 2.0, Peptamen 1.5, Jevity 1.2, Jevity 1.5 High nitrogen Osmolite HN, TwoCal HN, Fibersource HN, Peptamen VHP, Isosource HN Enteral Selection Disease specific Diabetes: Resource Diabetic, Diabetisource, Glucerna Select Pulmonary: Nutren Pulmonary, Pulmocare, Novasource Pulmonary, Oxepa Renal: Novasource Renal, Nepro, Suplena, Nutren Renal NutriHep (liver disease) Prosure (cancer) E