Feed composition

Most patients tolerate iso-osmolar, non-lactose feed. Carbohydrates are provided as sucrose or glucose polymers; protein as whole protein or oligopeptides (may be better absorbed than free amino acids in 'elemental' feeds); fats as medium chain or long chain triglycerides. Medium chain triglycerides are better absorbed. Standard feed is formulated at 1Cal/ml. Special feeds are available, e.g. high fibre, high protein-calorie, restricted salt, high fat or concentrated (1.5 or 2Cal/ml) for fluid restriction. Immune-enhanced feeds (e.g. glutamine-enriched or Impact ®, a formula supplemented with nucleotides, arginine and fish oil) may reduce nosocomial infections but no evidence of outcome benefit has been shown from large prospective studies.

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