| Macronutrients |
| Energy | 1000 to 1200 kcal/L |
| Water | Isotonic | Hypertonic (1800 mOsm/kg)
pH ~ 5.6 |
| Carbohydrates | 125g/L carbohydrates as glucose (500 kcal/L) |
| Protein |
- 50g/L protein as amino acids (200 kcal/L)
- contains all 9 essential amino acids
- lycine
- leucine
- isoleucine
- threonine
- methionine
- valine
- histidine
- tryptophan
- phenylalanine
|
| Lipids |
- 40g/L (360 kcal/L) lipids as soy and/or olive oil (+/- fish)
- contains both essential fatty acids (linoleic acid and alpha-linolenic acid)
|
| Micronutrients |
| Vitamins | Fat soluble vitamins: A, D, E, K Water soluble vitamins: B vitamins (B1-3, B5-7, B9, B12), C |
| Trace elements | Examples: iron, selenium, chromium, manganese, zinc, copper |
| Electrolytes | Na+: 40 mmol/L
K+: 30 mmol/L
Ca2+: 2.5 mmol/L
Mg2+: 5 mmol/L |
| Complications |
| Unique complications | Procedural complications:
- endobronchial nasogastric tube placement / pneumothorax
- aspiration
- viscous perforation
- surgical complications of percutaneous feeding tubes (PEG/PEJ)
Inadequate absorption may lead to underfeeding, which is more likely with enteral feeding. | Procedural complications of central venous access:
- vessel erosion
- line associated thrombus
- central-line associated bloodstream infection (CLABSI)
- inadverdent arterial cannulation
- bleeding
- pneumothorax
- air embolus
Infection
- predisposes to fungal infection due to fungal growth in the feeding solution
- predisposes to GI bacterial infection
- lack of enteral nutrition leads to ↓ stimulation of the GI tract
- → decreased GI blood flow and mucous production
- → increased risk of GI infection
Hypertonic fluid load predisposes to hypertonic dehydration. |
| Shared complications |
- Overfeeding
- too much sugar → hyperglycaemia, insulin resistance
- too much protein → uraemia, hyperammonaemia
- too much lipids → hypertriglyceridaemia, fatty liver, pancreatitis
- too much volume → hypervolaemia
- Underfeeding
- not meeting caloric requirements
- catabolism, muscle wasting
- micronutrient deficiency
- hypovolaemia
- Refeeding syndrome → electrolyte derangement
|
