Logic in selecting tube feeds?

[Yogi Bear]

For someone who needs to be on tube feeds, what's the logic in selecting? probalance, nepro, renacal, etc...

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[Blade28]

Depends on lots of factors. Your choice will be different for a burns patient, vs. HD-dependent, liver disease, CHF, trauma, etc.

Sometimes you'll choose the more calorically dense one because the patient can't handle the excess fluid load.

But mostly you're looking at protein amounts and picking based on comorbidities.

 

[gutonc]

This is why god made nutrition consults. For somebody w/o renal/liver failure or burns as above, go w/ some Nutren @ 1500-2000 kcal/d or so and see how things work out. It's not really rocket science but the upside of a nutrition consult is that they know what's on formulary and what sorts of supplements could be useful. In general, to get an intubated MICU pt through a couple of days on the vent I'll do the above w/ a nutrition c/s if they're going out of the MICU or on TF for >3d. Anybody getting TF access beyond a Dobhoff tube NEEDS nutrition help to determine caloric/nutrient needs and supplements.

 

[Winged Scapula]

My residency hospital had a process in which ANY patient on tube feeds automatically got a nutrition consult. Very helpful in many of the patients with MOSF.

 

[Blade28]

Agreed, Nutrition is your friend.

 

[elwademd]

My residency hospital had a process in which ANY patient on tube feeds automatically got a nutrition consult. Very helpful in many of the patients with MOSF.

in addition to the nutrition consult, it may also depend on the contract(s) that your hospital has. at my hospital, werecently changed contracts, and all of our tube feeds changed! easier for nutrition to stay up on that then me.