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Flow characteristics of enteral feeding with psyllium hydrophilic mucilloid added
L J Davidson1, D C Belknap, D J Flournoy
1College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City 73190.
Abstract:
One therapy for managing diarrhea in patients in intensive care units who are receiving enteral nutrition is administration of psyllium hydrophilic mucilloid (PHM). This laboratory study was conducted to determine whether the addition of PHM (Metamucil) to enteral feeding formula (Entrition) adversely affected the flow characteristics of the feeding formula through a small-bore feeding tube. Descriptive data were obtained from 72 trials of feeding formula with varied infusion rates, formula osmolality and temperature, and PHM concentrations. Two thirds (n = 48) of the trials were successful (PHM did not clog the tubing and obstruct flow). The remaining one third of the trials (n = 24) were unsuccessful. Successful formula infusion was influenced by formula temperature and osmolality but not by infusion rate, PHM concentration, or flow interruption. If formula with PHM was followed by formula without PHM, the infusion was successful regardless of infusion rate or formula osmolality. Thus, the data from this laboratory study indicate that when therapeutic doses of PHM are prescribed, it is feasible for PHM to be mixed in room-temperature feeding formula and infused without clogging the feeding tube.
Insights
Adding psyllium hydrophilic mucilloid (PHM) to enteral formula is feasible for managing diarrhea in ICU patients. Room-temperature formula with PHM can be infused without clogging feeding tubes, influenced by temperature and osmolality.
Area of Science:
- Gastroenterology
- Critical Care Medicine
- Pharmaceutical Science
Background:
- Diarrhea is a common complication in intensive care unit (ICU) patients receiving enteral nutrition.
- Psyllium hydrophilic mucilloid (PHM) is a potential therapy for managing such diarrhea.
- The compatibility of PHM with enteral feeding formulas and small-bore feeding tubes requires investigation.
Purpose of the Study:
- To evaluate the impact of adding psyllium hydrophilic mucilloid (PHM) to enteral feeding formula on its flow characteristics.
- To determine if PHM causes clogging or obstruction in small-bore feeding tubes during infusion.
Main Methods:
- A laboratory study involving 72 trials of enteral feeding formula with varying infusion rates, osmolality, temperature, and PHM concentrations.
- Descriptive data analysis to assess successful formula infusion and identify factors influencing flow.
- Testing scenarios with PHM-infused formula followed by non-PHM formula.
Main Results:
- Two-thirds (48/72) of the trials were successful, with no observed clogging or flow obstruction.
- Successful infusion was significantly influenced by formula temperature and osmolality.
- Infusion rate, PHM concentration, and flow interruption did not significantly affect successful infusion.
- Infusion was successful regardless of rate or osmolality when PHM-formula was followed by non-PHM formula.
Conclusions:
- Mixing psyllium hydrophilic mucilloid (PHM) with room-temperature enteral feeding formula is feasible for administration.
- PHM can be infused through small-bore feeding tubes without causing clogging under specific conditions.
- Formula temperature and osmolality are key factors to consider for successful PHM administration in enteral nutrition.