Enteral nutrition: frequency of formula modification

A retrospective study was undertaken to determine with what frequency one of the 12 standard enteral formulations routinely used by the Metabolic Support Service could not be used without modification. Forty-three percent of the 83 patients studied required modification of one or more of the 5 individual components of the enteral product being utilized (ie, carbohydrate, protein, fat, electrolytes, and vitamins). Organ dysfunction was the reason for 31% of those changes in formula, other conditions included vitamin deficiencies (30%), electrolyte imbalances (27%), and essential fatty acid deficiencies (12%). The results of the study confirm the fact that no single formula can be effective in meeting every patient's fluid and electrolyte requirements while addressing the specific nutritional aspects of their disease. It would appear that a totally modular system for enteral nutrition similar to that used in parenteral nutritional support would allow maximum flexibility in the preparation of formulae that conform to patient's needs.