Introduction Some long term, chronically ill, tube fed patients with severe central nervous system impairment, may have lower energy requirements than predicted and need very low energy tube feeding regimens (∼800 kcal total energy per day) to maintain weight.1 2 These patients receive a variety of different but nutritionally inadequate regimens, which can be complex and time consuming, with increased risk for errors and contamination3 This study aimed to compare the nutritional outcomes and practicality of using current tube feeding regimens, vs a specifically developed ready made 800 kcal nutritionally complete tube feed.
Methods Long term tube fed patients (n 15) with severe neuro-disorders (mean age: 51 yrs (SD 14), mean BMI: 24 kg/m2 (SD 2.5), mean time receiving ≤1000 kcal/d: 3 yrs (SD 3.5)) requiring ∼800 kcal/d, received their current tube feeding regimen (either 1000 kcal nutritionally complete tube feeds or a mixture of feeding products (a tube feed, protein powder and powdered vitamin and mineral preparations)) for 1 wk, followed by 800 kcal/1000 ml per day of a ready made nutritionally complete tube feed (Nutrison 800 Complete Multi Fibre) for 4 wks. Nutritional outcomes (nutritional intakes, body weight) and practicality (ease of use, time to prepare and administer, acceptability and preference) were assessed weekly. NHS research ethics approval for this study was received in January 2011.
Results The proportion of patients meeting their energy requirements (100% vs 47%), and their RNIs for protein (100% vs 87%) and vitamins & minerals (100% vs 53%) was substantially greater with the ready made tube feed vs current regimens. Use of the ready made tube feed significantly increased the percentage of patients meeting their weight goals (86% vs 35%, p=0.003). 86% of nursing staff preparing and administering the regimens preferred the ready made tube feed (p=0.013) and rated it better for ease of preparation (100% vs 78%) and use (93% vs 79%). Preparation and administration of the current regimens took on average 15–55 min longer per patient per day than the ready made tube feed.
Conclusion The ready made 800 kcal nutritionally complete tube feed provided a more nutritionally adequate intake than current tube feeding regimens. It was also practically easier and quicker to use than current regimens, allowing more appropriate utilisation of healthcare resource and time, providing an easier solution for the use of low energy tube feeding regimens in the home care setting.
Competing interests G Hubbard Employee of: Nutricia, H Finch: None declared, R Stratton Employee of: Nutricia.
References 1. Dickerson RN, Brown RO, Gervasio JG, et al. J Am Coll Nutr 1999;18:61–8.
2. Leone, Pencharz. Clin Nutr 2010;29:370–2.
3. Hubbard, et al. Presented at BAPEN. 2011.