ENTERAL NUTRITION REPORT

Submitted by:

Catigbe, Joshua Robin

Cairo, Justin

Caparoso, Rico Robin

Chiong, Dominic Andre

Coliflores, Luke Raffi

Cubio, Ivan Joseph

Du, Regil Kent

Macasling, Danielle

Salonoy, April Justine

Sta. Ana, Lauren

Tolibas, Earl Adrian

Uy, Kent Benedict

 TABLE OF CONTENTS

Page No.

I. INTRODUCTION

II. DEFINITION

III. INDICATION/ CONTRAINDICATION

IV. ALGORITHM

V. DIFFERENT ACCESS/ROUTES

VI. ADMINISTRATION OF ENTERAL FEEDING

VII. TYPES OF ENTERAL NUTRITION

a. Adult Formulas (Open System/Close System)

i. Polymeric

ii. Elemental/Semi-elemental

iii. Modular

b. Pediatric Formulas

i. Polymeric

ii. Elemental/Semi-Elemental

iii. Modular

VIII. TYPES OF ENTERAL NUTRITION BASED ON DISEASE CONDITION

a. Renal

b. Diabetes

c. Cancer

d. Lung Injury

IX. PRODUCT ALGORITHM (SUMMARY)

X. REFERENCES
I. Introduction

All humans need food to live. Sometimes a person cannot eat any or enough
food because of an illness. Others may have a decreased appetite, difficulties in
swallowing, or some type of surgery that interferes with eating. When this occurs, and
one is unable to eat, nutrition must be supplied in a different way. One method is
“enteral nutrition” or “tube feeding.”

Normal digestion occurs when food is broken down in the stomach and small
intestine, then absorbed in the bowels. These absorbed products are carried by the
blood to all parts of the body (ASPEN, 2008). When patients have problems with eating
or digestion, it is sometimes necessary to provide nutrition with artificial food, which is
specially formulated to provide the right balance of fats, proteins, sugars, vitamins and
minerals. These artificial preparations can be delivered into the gut to be absorbed in
the usual way, which is known as Enteral Nutrition. If the gut is working normally to
absorb food and nutrients, then Enteral Nutrition is the preferred way of delivering
nutritional support. In some patients, enteral nutrition may have to be delivered into the
gut through a tube, but in others it may be possible for them to take this by mouth
(BAPEN, 2018).
II. Definition

Enteral Nutrition (EN) refers to the delivery of nutrients into the gastrointestinal
tract either by mouth or through a feeding tube. It includes food, oral supplements,and
formulas created specifically to prevent malnutrition and accommodate nutrient needs
in various disease states. Obstacles to oral intake have many causes, including
gastrointestinal disease, swallowing inabilities, or increased nutrient needs related to
critical illness or wound healing.

The use of EN is to target specific immune-related and physiologic processes and

after the course of disease is an exciting aspect of enteral nutrition support that is
supported by a robust research platform. When a patient has been determined to be
a candidate for EN, the location of nutrient administration and type of enteral access
device is selected. Enteral access selection depends on the
(1) Anticipated length of time enteral feeding will be required
(2) Degree of risk for aspiration or tube displacement
(3) Patient’s clinical status
(4) Presence or absence of normal digestion and absorption
(5) Patient’s anatomy
(6) Whether a surgical intervention is planned

In a closed enteral system the container or bag is prefiled with sterile liquid
formula by the manufacturer, and is ready to administer. In an open enteral system, the
person administering the feeding must open and pour the feeding in the container or
bag. Both systems are effective sanitation is a priority.

III. Indication/Contradiction
Indications: (Mahan, et al., 2017)
1. Conditions that make the patient unable to eat
a. Neurologic disorders (dysphagia)
b. Facial trauma
c. Oral or esophageal trauma
d. Congenital anomalies
e. Respiratory failure (on a ventilator)
f. Traumatic brain injury
g. Comatose state
h. GI surgery (e.g., esophagectomy)
2. Condition that prevent the patient from eating enough
a. Hypermetabolic states such as with burns
b. Cancer
c. Heart failure
d. Congenital heart disease
e. Impaired intake after orofacial surgery or injury
f. Anorexia nervosa
g. Failure to thrive
h. Cystic fibrosis
3. Conditions that result in impaired digestion, absorption, and metabolism in the
patient
a. Severe gastroparesis
b. Inborn errors of metabolism
c. Crohn’s disease
d. Short bowel syndrome with minimum resection
e. Pancreatitis
Contraindications:
1. According to Howard (2009) general contraindications include:
a. absence of intestinal function due to failure, severe inflammation or, in
some instances, post operative stasis
b. complete intestinal obstruction
c. inability to access the gut e.g. severe burns, multiple trauma
d. high loss intestinal fistula
e. relative contraindication to tube feeding is also increased likelihood of
opportunistic infection e.g. maxillo-facial surgery or oncology treatments
f. ethical considerations e.g. terminal care.
2. Additionally, an update from Singer, et al. (2019) expounds that
contraindications also include:
a. Critically ill patients with:
i. Uncontrolled shock,
ii. Uncontrolled hypoxemia and acidosis
iii. Uncontrolled upper GI bleeding
iv. Gastric aspirate >500 ml/6 h
v. Bowel ischemia
vi. Bowel obstruction
vii. Abdominal compartment syndrome,
viii. High-output fistula without distal feeding access.
IV. Algorithm
V. Different Access/ Routes
 Determination of the site and route of EN should consider an individual’s
anticipated length of feeding time; their medical condition or disease state, including
anatomical barriers within the gastrointestinal tract; and the surgical options for that
individual.

Short-term Enteral Access

Short-term placement is for patients

who need short-term feeding, a
nasoenteric or oroenteric method is
used.

1. Nasoenteric tubes - can be

placed at the bedside,
endoscopically, or
fluoroscopically. Postpyloric
placement of nasoenteric
tubes is used if a patient has
gastric complications or
aspiration risk but otherwise
normal small intestine function.
2. Nasogastric tube placement- is
appropriate for patients who have normal gastric function. A tube is entered
through the nose or mouth and is placed directly into the stomach. Feedings
can be administered by bolus injection or intermittent or continuous infusions.
Tube placement is verified by aspirating gastric contents in combination with
auscultation of air insufflation into the stomach or radiographic confirmation of
the tube tip location.
3. Nasoduodenal tube feeding- requires the tube be placed from the nose,
through the stomach, to the duodenum of the small intestine. Short term enteral
nutrition support of up to 3 or 4 weeks in patients with gastric motility disorders,
esophageal reflux, or persistent nausea and vomiting.
4. Nasojejunal tube feedings- requires that the tube is placed from the nose and
advanced to the jejunum of the small intestine. While nasogastric tubes can
 usually be placed at the bedside, nasojejunal tubes are better placed with
endoscopic or fluoroscopic methods.
5. Fluoroscopic Nasoenteric Tube Placement- It involves using x-ray imaging as a
guide when placing the feeding tube from the nose to the stomach or small
intestine. While there is success with this technique, it is not used as often as the
bedside or endoscopic techniques because of the radiation exposure or if the
patient requires bedside attention due to critical illness.

Long term Placement

1. Percutaneous endoscopic
gastrostomy (PEG-J) - is the
most common long-term
tube placement method.
After a small incision is
made, a needle is placed
through the abdominal
wall and into the stomach
so that a guidewire can be
placed through the
needle.
2. Percutaneous endoscopic
jejunostomy (PEJ)- if the
patient has gastric
complications, a
percutaneous endoscopic jejunostomy can be performed. If there is an existing
gastrostomy tube, a transpyloric feeding tube can be placed through the
previously placed PEG tube and placed endoscopically into the jejunum.

VI. Administration of Enteral Feeding

The three common methods of tube-feeding administration are (1) bolus feeding, (2)
intermittent drip, and (3) continuous drip. Method selection is based on the patient’s
clinical status, living situation, and quality-of-life considerations. One method can serve
as a transition to another method as the patient’s status changes.

1. Bolus Feeding
a. Bolus feeding is a way of receiving a set amount of feed as required,
without use of a feeding pump. EN is administered via a syringe or gravity
drip over a 4-10-min period. Delivered four to eight times per day; each
feeding lasting about 15 to 30 minutes. Feedings are given at 50-100 ml
every 4 hours.
b. Used for Nasogastric and Gastrostomy tubes.
c. Gravity Feeding
i. Gravity feeding (with or without a gravity feeding set), where
gravity naturally draws the feed through into feeding tube,
d. Syringe Feeding
i. Syringe feeding, where the feed may need help to be pushed
through your feeding tube using the syringe with its plunger.

2. Intermittent Drip
a. In intermittent feeding, EN is administered over 20-60 min every 4-6 h with
or without a feeding pump.
b. Formula administration is initiated at 100 to 150 mL per feeding and
increased incrementally as tolerated. Success with this method of feeding
depends largely on the degree of mobility, alertness, and motivation of
the patient to tolerate the regimen.

3. Continuous Drip
a. This method provides a slow infusion of feedings into the stomach or small
intestine on an hourly basis. Using this method decreases risk for aspiration
and gastric distention. It tends to be the most easily tolerated because of
its gradual delivery of feeding, and it allows for greater nutrient uptake in
patients who may have marginal absorptive capacity. It also reduces the
effect of thermogenesis.
b. The feeding rate goal, in milliliters per hour, is set by dividing the total daily
volume by the number of hours per day of administration (usually 18 to 24
hours). Feeding is started at one quarter to one half of the goal rate and is
advanced every 8 to 12 hours to the final volume.
 c. Used for Nasojejunal, Nasodoudenal, Jejunostomy tubes

Complications of Enteral Nutrition through Administration

1. Microbial Contamination
2. Misplacement of tube, causing infection or aspiration pneumonia or peritonitis
3. Regurgitation
4. Constipation
5. Diarrhea
6. Perforation
7. Obstruction

VII. Types of Enteral Nutrition

A. Adult Formulas (Open System/Close System)

a. Polymeric (Tolibas & Cubio)

A nutritional drink that may help people who cannot get everything they need
in their diet from foods and other drinks. It may be taken by mouth or given
through a small tube inserted through the nose into the stomach or the small
intestine. It may also be given through a small tube that is put into the stomach
or intestinal tract through an opening made on the outside of the abdomen.
Polymeric formulas contain whole proteins, complex carbohydrates, and long
chain triglycerides, meaning the nutrients are intact and have not been broken
down, which requires additional work by the digestive system. For individuals
who have full digestive function, there is no issue digesting a polymeric formula.
They may also include fiber, and depending on the formula, may be consumed
orally or via a tube. Polymeric formulas are often used for longer periods of time
(6+ weeks) and are less expensive than elemental or semi-elemental formulas.

Formula kcal/scoop, gm/ scoop,

Macronutrients/ scoop
Magnesium, Potassium, Phosphorus, Calcium Content
Preparation, caloric density, and Flavor

Osmolite Kcal: 250kcal

Serving Size: 237ml
Macro: CHO-33.9g, ChoN-10.5g, Fat- 8.2g
Calcium: 206mg
Magnesium: 63 mg
Phosphorus: 198 mg
Potassium: 372 mg
Sodium: 220 mg
Preparation: Ready to hang (RTH)
Caloric Density: 1.06 kcal/ml
Flavor: Unflavored

Promote Kcal: 1000 kcal

Serving Size: 33.8 fl oz
Macro: CHO-130g, ChoN-63g, Fat- 26g

Magnesium: 280 mg
Potassium: 2667 mg
Phosphorus: 833 mg
 Calcium: 867 mg
Preparation: Ready to hang (RTH)
Caloric Density: 1.0 kcal/ml
Flavor: Unflavored

Nutren 1.0 Kcal: 250 kcal

Serving Size: 250ml
Macro: CHO-34g, ChoN-10g, Fat-8.5g
Magnesium: 0.8 mg
Potassium: 400 mg
Phosphorus: 200 mg
Calcium: 200 mg
Preparation: Ready to hang (RTH)
Caloric Density: 1.06 kcal/ml
Flavor: Unflavored

Jevity 1.0 Kcal: kcal

Serving Size: 33.8 fl oz
Macro: CHO-51.1g, ChoN-15.1g, Fat-11.8g
Magnesium: 1.0 mg
Potassium: 517 mg
Phosphorus: 296 mg
Calcium: 308 mg
Preparation: Ready to hang (RTH)
Caloric Density: 1.0 kcal/ml
Flavor: Unflavored

Jevity Plus Kcal: 120 kcal

Serving Size: 1000ml
Macro: CHO-15.07g, ChoN-5.55g, Fat-3.93g
Magnesium: 24 mg
Potassium: 185 mg
Phosphorus: 80 mg
Calcium: 80 mg
Preparation: Ready to hang (RTH)
Caloric Density: 1.g kcal/ml
Flavor: Unflavored
Promote w/ Kcal: 1000 kcal
Fiber Serving Size: 33.8 fl oz
Macro: CHO-138g, ChoN-63g, Fat- 28g
Magnesium: 280 mg
Potassium: 2200 mg
Phosphorus: 933 mg
Calcium: 867 mg
Preparation: Ready to hang (RTH)
Caloric Density: 1.0 kcal/ml
Flavor: Unflavored

Nutren w/ Fiber Kcal: 250 kcal

Serving Size: 250ml
Macro: CHO-37g, ChoN-10g, Fat- 8.5g
Magnesium: 70 mg
Potassium: 400 mg
Phosphorus: 200 mg
Calcium: 200 mg
Preparation: Ready to hang (RTH)
Caloric Density: 1.0 kcal/ml
Flavor: Unflavored

Replete w/ Kcal: 250 kcal

Fiber Serving Size: 250ml
Macro: CHO-31g, ChoN-16g, Fat- 8.5g
Magnesium: 70 mg
Potassium: 400 mg
Phosphorus: 200 mg
Calcium: 200 mg
Preparation: Ready to hang (RTH)
Caloric Density: 1.0 kcal/ml
Flavor: Unflavored

Twocal HN Kcal: 200kcal

Serving Size: 100ml
Macro: CHO-21.85g, ChoN-8.35g, Fat-9.05g (per 100kcal)
Calcium: 105mg
Magnesium: 42.5 mg
Phosphorus: 105 mg
Potassium: 244 mg
Sodium: 1445 mg
 Preparation: Pump Feeding is recommended
Caloric Density: 2.0kcal
Flavor:Vanilla

Ensure Plus HN Kcal: 375kcal (150kcal/ 100ml)

Serving Size: 250ml
Macro: CHO-20g, ChoN- 6.25g, Fat- 5g (per 100kcal)
Calcium: 92 mg
Magnesium: 30 mg
Phosphorus: 92 mg
Potassium: 182 mg
Sodium: 118 mg
Preparation: ready Drink, Ready to hang (RTH)
Caloric Density: 1.5kcal
Flavor: Unflavored, Vanilla

Jevity HiCal Kcal: 375 kcal (150kcal/100ml)

Serving Size: 250ml
Can Macro: CHO-20.10g, ChoN-6.38g, Fat- 4.90
Calcium: 100mg
Magnesium: 31mg
Phosphorus: 100mg
Potassium: 165 mg
Sodium: 140mg
Preparation: Ready to hand (RTH)
RTH
Caloric Density: 1.5kcal
Flavor: Unflavored
Ensure powder Kcal: 262kcal (1serving)
(HMB) Serving Size: 230ml
Macro: CHO-34.9G , CHON-10.5G , FAT-8.48G
Calcium: 273mg
Magnesium: 55.8mg
Phosphorus: 158 mg
Potassium: 46 mg
Sodium: 194 mg
Preparation:
Caloric Density: 1.2
Flavor: Vanilla

Complete balanced nutrition that contains: HMB and protein that

Abbot supports tissue building and growth, Vit. B1, B2,B3 and B6. Calcium &
phosphorus for strong bones

Boost Optimum Kcal: 250kcal (1 serving)

Serving Size: 210 ml
Macro: Cho-29.3g, Chon-9.9g, Fat-9.6g
Calcium: 258.5 mg
Magnesium: 62.2 mg
Phosphorus: 144.9 mg
Potassium: 376.8 mg
Sodium: 115.5 mg
Preparation: Powder
Caloric Density: 1.2
Nestle Flavor: Vanilla

BOOST™ OPTIMUM active adult nutritional drink is specifically

designed with proteins, probiotics, prebiotics, vitamins and minerals to
address changing nutritional needs as you age. BOOST™ OPTIMUM
may help improve your nutritional status and physical performance in
as early as 6 weeks* when combined with proper diet and exercise

Nutribest Kcal: 259kcal (1 serving)

Serving Size: 4 scoops(57g)
Macro: Cho-27g, Chon-14g, Fat-
Calcium: 23 mg
Magnesium: 33 mg
Phosphorus: 23 mg
 Potassium: 10 mg
Sodium: 11 mg
Preparation: Powder
Caloric Density: 65 kcal/scoop (14.25)
Flavor: Vanilla, Choco, Strawberry

Nutritionally complete drink especially formulated for adults (19 y.o

and older) in powder format. It is indicated for people at risk of
malnutrition. Source of whey protein, fructooligosaccharides and
DHA, gluten free, fructose free, transfat free.

Hinex jelly Kcal: 100 kcal (1 serving)

Serving Size: 300g pouch
Macro: Cho- 15.7g - Chon -5.0g, Fat- 2.5g
Calcium: 94 mg
Magnesium:
Phosphorus: 75mg
Potassium: 156mg
Sodium: 0.44mg
Preparation: Gently squeeze before opening
Caloric Density:
Flavor: Honey

Hinex Jelly is classified as a source of general nutrients used for enteral

nutrition
 b. Elemental/Semi-elemental (Tolibas & Cubio)

Elemental formulas contain individual amino acids, are low in fat, especially
Long chained triglycerides (LCTs), varying length, simple carbohydrates, and
Medium chain triglycerides MCTs and as such, are thought to require minimal
digestive function and cause less stimulation of exocrine pancreatic secretion. In
many products, MCT is the predominant fat source, and can be absorbed
directly across the small intestinal mucosa into the portal vein in the absence of
lipase or bile salts; they are believed to be beneficial in malabsorptive states.
They are also considered to be advantageous in patients with acute
pancreatitis, and in those with other malabsorptive states.

Semi-elemental formulas contain amino acids of varying length, simple carbohydrates,

and MCTs. They are partially pre-digested but not fully pre-digested. An example is
Peptamen ®.

Formula kcal/scoop, gm/ scoop,

Macronutrients/ scoop
Magnesium, Potassium, Phosphorus, Calcium Content
Preparation caloric density and Flavor

Peptamen Kcal: 456kcal (100g)

Serving Size: 210 ml (6scoops)
Macro: Cho-57.2g , Chon-18.5g , Fat-18g
Calcium: 370 mg
Magnesium: 186mg
Phosphorus: 325 mg
Potassium: 580 mg
Sodium: 365 mg
Preparation: Powder
Caloric Density:
 Flavor: Vanilas

Peptamen® formula is a nutritionally-complete peptide-based

formula specifically designed for people who cannot digest or
absorb nutrients from conventional foods. Balanced peptide profile
promotes GI absorption and tolerance. May be used for tube feeding or
oral supplementation. Gluten-free and lactose intolerance

AlitraQ Kcal: 302kcal

Serving Size: per 300 ml
Macro: Cho-49.3g, Chon- 15.8g, Fat- 0g
Calcium: -
Magnesium: -
Phosphorus: -
Potassium: -
Sodium: -
Preparation: Mix Contents of sachet
Caloric Density: 76 grams of sachet
Flavor: Vanilla

Semi-elemental, normocaloric, high-protein formula, enriched with

glutamine and arginine for patients with gastrointestinal disorders.

Juvenaid Kcal: 296 kcal

Unilab Serving Size: 100g per sachet
Macro: Cho- 15.4g, Chon-58g, Fat-0g
Calcium: -
Magnesium: -
Phosphorus: -
Potassium: -
Sodium: -
Preparation: Mix Contents of sachet
Caloric Density: 25g per sachet
Flavor: Orange

JuvenAid™ is a nutritional drink for the dietary management of patients

who are fatigued due to surgery or needs to build-up lean body mass.
Lean body mass is vital for recovery, tolerance to therapy and helps to
resume normal daily activities.
 c. Modular Formula (Tolibas & Cubio)

A modular formula is an incomplete liquid supplement that contains specific nutrients,

usually a single macronutrient (carbohydrate, protein or fat).

Different modules can be combined to result in a nutritionally complete diet. Modular

diets can be tailored to an individual's needs but are generally complex to design, and
may fail to meet all of the patient's nutritional needs. An example of this is
Beneprotein®.

Formula kcal/scoop, gm/ scoop,

Macronutrients/ scoop
Magnesium, Potassium, Phosphorus, Calcium Content
Preparation caloric density and Flavor

Beneprotein Kcal: 25 kcal

Serving Size: 120 ml(7g)
Macro: Cho- 6g
Calcium: 2%
Magnesium: -
Phosphorus: -
Potassium: 35 mg
Sodium: 15g
Preparation: Powder
Caloric Density:
Flavor: -

Beneprotein® instant protein powder is a concentrated source of whey

protein. Each 7 g serving provides 6 g of protein. It can be added to most
foods, liquids and as a "protein flush" with tube feedings.

Neomune Kcal: 254 kcal

Serving Size: 60g
Macro: Cho- 32g, Chon-16g,Fat-7g
Calcium: 150mg
Magnesium: 71mg
Phosphorus: 57mg
Potassium: 252mg
Sodium: 200mg
Preparation: Mix powder of Neo-Mune and dissolve in warm water
Caloric Density: 8.5g per scoop
Flavor: Unflavored

Neo-Mune is a well-balanced diet which can be used as a source of

nutrition and supplement. It is formulated with Vitamins, Minerals, 5.21g
Arginine, 2.61g L-glutamine, 2.32g Fish oil in 100g powder. It is a high protein
and high calorie nutrition.
 d. Disease Specific Formula (Tolibas & Cubio)

Specialty formulations are available for patients with unique ‘‘disease specific’’ or
‘‘organ specific’’ nutritional requirements. This is a growing area of enteral nutrition,
where improved knowledge of disease processes has led to the development of a
multitude of specialty products. Currently specially designed formulas exist for liver
disease, renal disease, diabetes, pulmonary insufficiency, heart failure, GI dysfunction
as well as situations of metabolic stress such as trauma or sepsis. These products are
more expensive than standard enteral nutrition and may result in complications when
used inappropriately.

Formula kcal/scoop, gm/ scoop,

Macronutrients/ scoop
Magnesium, Potassium, Phosphorus, Calcium Content
Preparation caloric density and Flavor

Glucobest Kcal: 229 kcal

Serving Size: 52g (1 serving)
Macro: Cho- 29.6, ChoN-11.1 , Fat-79.2
Calcium: 252mg
Magnesium: 103mg
Phosphorus: 138 mg
Potassium: 343mg
Sodium: 208mg
Preparation: Powder
Flavor: Vanilla and Chocolate

Diabetasol Kcal: 260 kcal

Serving Size: per 60 g (4 tbsp)
Macro: 39 g CHO, 10 g CHON, 7 g Fat
Calcium:
Magnesium:
Phosphorus:
Potassium: 192 mg
Sodium: 90 mg
Preparation: Powder-form
Caloric Density: 4.3 kcal/g
 Flavor: Vanilla & Chocolate

Glucerna SR Kcal: 266 kcal

Serving Size: per 52.6 g
Macro: 21.44 g CHO, 10.16 g CHON, 8.28 g Fat
Calcium: 168 mg
Magnesium: 59 mg
Phosphorus: 168 mg
Nutrition for
Potassium: 370 mg
people with
Sodium: 211 mg
diabetes
Preparation: Powder form
Caloric Density: 4.4 kcal/ml
Flavor: Vanilla

Nutren Kcal: 252 kcal

DIABPRO Serving Size: 55 g powder
Macro: 24.5 g CHO, 11.3 g CHON, 11 g Fat
Calcium: 204 mg
Magnesium: 46 mg
Phosphorus: 138 mg
Potassium: 240 mg
- For
Sodium: 237 mg
pre-
Preparation: Mix 55 g of powder in 210 ml of water
diab
Caloric Density: 4.6 kcal/ml
etic
Flavor: Vanilla
patie
nts,
man
age
ment
 of
DM
type I
&
type
II
patie
nts,
and
GDM

Abbot Kcal: 501 kcal per 100 g

[Nepro HP] Serving Size: per 100 ml
Macro: 43.5 g CHO, 21.6 g CHON, 25.6 Fat
Calcium: 282 mg
Magnesium: 56.1 mg
Phosphorus: 191 mg
Potassium: 282 mg
Sodium: 149 mg
Preparation: To prepare 237ml serving providing 446kcal, pour 167ml of clean,
sterile water at room temperature in a glass and gradually add 10 level scoops
or 89g of powder while stirring and mix until dissolved.
Caloric Density: 5.01 kcal/ml
Flavor: Vanilla

For patients on dialysis, Suitable for malnourished, non-dialyzed CKD patients

with elevated protein needs, For oral or tube feeding

Abbot Kcal: 504 kcal per 100 g

[Nepro LP] Serving Size: per 100 ml
Macro: 52.3 g CHO, 12.19 g CHON, 26.12 Fat
Calcium: 288 mg
Magnesium: 57 mg
Phosphorus: 195 mg
Potassium: 312 mg
Sodium: 171 mg
Preparation: To prepare 236ml serving providing 438kcal, pour 170ml of clean,
sterile water at room temperature in a glass and gradually add 9 level scoops
or 87 g of powder while stirring and mix until dissolved.
Caloric Density: 5.04 kcal/ml
Flavor: Vanilla
 For patients on non-dialysis CKD patients requiring low protein diet, For oral or
tube feeding

Nestle Kcal: 475kcal

[Novasourc Serving Size: per 237 mL
e® Renal] Macro: 43g CHO, 22g CHON, 24g FAT
Calcium: 200mg
Magnesium: 50mg
Phosphorus: 200mg
Potassium: 230mg
Sodium: 220mg
Preparation: Powder-form
Caloric Density: 2 kcal/mL
Flavor: Vanilla

For patients with acute or chronic renal disease or those needing electrolyte
restriction, For oral or tube feeding.

Fresenius Kcal: 400kcal

Kabi Serving Size: 200mL
[Fresubin® Macro: 106g CHO, 6g CHON, 80g FAT
renal] Calcium:
Magnesium:
Phosphorus: low
Potassium: low
Sodium: low
Preparation: Ready to drink
Caloric Density: 2.0kcal/mL
Flavor: Tropical fruit

For predialysis patients with chronic or acute renal failure

Kalbe Kcal: 260kcal

[Nephrisol] Serving Size: 4 scoops (61g)
Macro: 48g CHO, 5g CHON, 6g FAT
Calcium: 120g
Magnesium: 20mg
Phosphorus: 79 mg
Potassium: 46mg
Sodium: 87 mg
 Preparation: Powder-form
Caloric Density: 1.04kcal/mL
Flavor: Vanilla

Formulated to meet requirements for those with renal insufficiency, and help
delay CKD progression for patients on pre dialysis stage

Supportan Kcal: 33.36

Serving size: 220 ml
Macro: 5. 38g CHO - 1.76g CHON - 0.68g FAT
Calcium: 39.5 mg
Magnesium: 90.6 mg
Supportan® Phosphorus: 336 mg
Drink is Potassium: 53 mg
prescribabl Sodium: 40 mg
e on Preparation: in 190 ml of water, add 9 level scoops of prosure powder
FP10/GP10 Caloric Density: 1.3 kcal/g
and Flavor: Vanilla, orange & banana
intended for
the dietary
manageme
nt of
patients
with
pancreatic
cancer and
patients
with lung
cancer
undergoing
chemother
apy.

Fresubin Kcal: 200 kcal

Serving Size: 200 ml
Macro: 27.6 g CHON - 7.6 g CHO - 6.8 g fat
Calcium: 120 mg
Magnesium: 40mg
Fresubin® Phosphorus: 94 mg
Original Potassium: 250 mg
Drink is a Sodium: 150 mg
nutritionally Preparation: Ready-to-drink
complete Caloric Density: 1 kcal/ml
1kcal/ml Flavor: Vanilla
oral
nutritional
supplement,
fiber free.
Clinically
free from
lactose,
gluten free.
For the
dietary
manageme
nt of
patients
with or at
risk of
disease-
related
malnutrition

Oral Impact Kcal: 310 kcal

Serving Size: 74 g
Macro: 42 g CHON - 17 g CHO - 7 g fat
Calcium: 185 mg
Magnesium: 37 mg
ORAL
Phosphorus: 170 mg
IMPACT® is
Potassium: 318 mg
used for the
Sodium: 257 mg
dietary
Preparation: Powder-form
manageme
Caloric Density: 4.19 kcal/g
nt of surgery
Flavor: Tropical Fruit Flavor
and
malnutrition
or at risk of
malnutrition
in cancer
patients.
ORAL
IMPACT®
contains
Immunonutri
ents:
Arginine,
Omega 3,
Nucleotides.

Prosure Kcal: 33.36

Serving size: 220 ml
Macro: 5. 38g CHO - 1.76g CHON - 0.68g FAT
Calcium: 39.5 mg
Magnesium: 90.6 mg
Phosphorus: 336 mg
Potassium: 53 mg
ProSure is an Sodium: 40 mg
energy- Preparation: in 190 ml of water, add 9 level scoops of prosure powder
dense, high Caloric Density: 1.3 kcal/g
protein Flavor: Vanilla, orange & banana
nutrition
with EPA*,
specially
designed
for patients
with
cancer-
induced
weight loss
or weight
loss due to
cancer
therapy

Oxepa Kcal: 759 kcal

Serving Size: 500 ml bottle
Macro: 14.05 g CHO - 8.35 g CHON - 27.6 g fat
Calcium: 530 mg
Magnesium: 212.5 mg
 Phosphorus: 530 mg
Potassium: 980 mg
Sodium: 25.05 mg
Preparation: Ready-to-hang
Caloric Density: 1.52 kcal/ml
Flavor: Unflavored

Oxepa is a 1.5 kcal/ml tube feed enriched with eicosapentaenoic acid (EPA),
gamma linolenic acid (GLA) and antioxidants. It has been specifically
designed for the management of people with Acute Lung Injury (ALI), Acute
Respiratory Distress Syndrome (ARDS), and/or Systemic Inflammatory Response
Syndrome (SIRS). It is available in a 500 ml Ready to Hang bottle, which
attaches directly to Abbott giving sets.

Nutren Kcal: 375

Pulmonary Serving Size: per 250 ml
Macro: 25g CHO - 17g CHON - 23.7g FAT
Calcium: 300 mg
Magnesium: 120 mg
Phosphorus: 300 mg
Potassium: 468 mg
Sodium: 292 mg
Preparation: ready to drink
Caloric Density: 1.5 kcal/ml
Flavor: Vanilla

Nutren® Pulmonary is a complete liquid nutrition formulated for people with

chronic respiratory disease. NUTREN® PULMONARY has a carbohydrate and fat
profile to help reduce carbon dioxide production. Can be used as a tube
feeding or oral supplement.

Pulmocare Kcal: 1500 kcal

Serving Size: 1 Liter container
Macro: 105.7 g- 62.6g- 93.3g
Calcium: 1060 mg
Magnesium: 425 mg
Phosphorus: 1060 mg
Potassium: 1780 mg
Sodium: 1310 mg
Preparation: Ready to hang
Caloric Density: 1.5 kcal/ml
 Flavor: Vanilla

PULMOCARE is designed for people with chronic obstructive pulmonary

disease (COPD), cystic fibrosis, or respiratory failure who may benefit from a
high-calorie, modified carbohydrate and fat enteral formula that may help
reduce diet-induced carbon dioxide production. For tube or oral feeding. For
supplemental or sole-source nutrition. Use under medical supervision.

VII. Pedia formulas

Polymeric

Polymeric Standard Value

Composition Formula Brand Specifics Additional

Name Details

Milk based Boost® Kid Contains Soy Gluten-free,

Essentials, kosher, suitable
Nestlé Health for lactose
Science intolerance

Milk based Boost® Kid Gluten-free,

Essentials 1.0, kosher, suitable
Nestlé Health for lactose
Science intolerance
Milk based PediaSure® Gluten-free,
Enteral Formula halal, kosher,
1.0 Cal, Abbott suitable for
lactose
intolerance

Milk based PediaSure® Gluten-free,

Enteral Formula halal, kosher,
1.0 Cal with suitable for
Fiber, Abbott lactose
intolerance

Milk and Soy Nutren Junior®, Contains soy Gluten-free,

protein Nestlé Health suitable for
Science lactose
intolerance,
Kosher

Milk and Soy Nutren Junior® Contains soy Gluten-free,

protein Fiber, Nestlé suitable for
Health Science lactose
intolerance,
Kosher

Milk and Soy PediaSure® Gluten-free,

protein Grow & Gain halal, kosher,
Therapeutic suitable for
Nutrition Shake, lactose
Abbott intolerance

Milk and Soy PediaSure® Gluten-free,

protein Grow & Gain halal, kosher,
with Fiber suitable for
Therapeutic lactose
Nutrition Shake, intolerance
Abbott
Milk and Soy Pediasure Gluten-free,
protein Sidekicks® 0.63 halal, kosher,
cal Shake, suitable for
Abbott lactose
intolerance

Organic Pea Kate Farms Vegan, no milk, Gluten-free,

protein Pediatric no soy, no lactose
Standard 1.2, gluten, no nuts,
Kate Farms® no corn

Soy protein Soy Pediatric Vegetarian, Gluten-free,

Drink®, Bright milk free, may lactose, kosher
Beginnings be suitable for
cow milk
allergy,
contains soy

Milk and Soy PediaSure® Contain soy Gluten-free,

protein Grow & Gain halal, kosher,
with Fiber, suitable for
Abbott lactose
intolerance

Food Compleat® No soy, no corn Gluten-free,

ingredients Pediatric suitable for
Reduced lactose
Calorie, Nestlé intolerance
Health Science

Compleat® No soy, no corn Gluten-free,

Pediatric, suitable for
Nestlé Health lactose
Science intolerance
FORMULA SPECIFICS INDICATION

Boost® Kid Essentials, Protein 14% Inadequate Oral Intake

Nestlé Health Science Carbohydrate 13% Increased Energy Needs
Sodium 150 mg 7% Malnutrition
Total fat 9g 12% Nutritionally appropriate
Cholesterol 5 mg 2% for ages 1 year and older
Shortened Feeding
Schedules
Weight Maintenance

Boost® Kid Essentials 1.0, Protein 12%

Nestlé Health Science Carbohydrate 54% Inadequate Oral Intake
Fat 34% Increased Energy Needs
Sodium 7 mEq Malnutrition
Calcium 17 mEq Nutritionally appropriate
Potassium 9 mEq for ages 1 year and older
Chloride 7 mEq Weight Maintenance

PediaSure® Enteral Protein 7g May be used as the sole

Formula 1.0 Cal, Abbott Fats 9 g source of nutrition or as a
 Sat. Fat 2.5 g supplement
Poly. Fat 2.5 g Specially formulated for
Mono. Fat 3.5 g tube-feeding
Cholesterol 5 mg Not intended for infants
Carbohydrate 33 g under one year of age
unless specified by a
physician
Not for IV use
Not for children with
galactosemia
Use under medical
supervision

Nutren Junior®, Nestlé Protein 12% Growth failure

Health Science Carbohydrate 45% Malnutrition
Fat 43% Short- or long-term tube
Sodium 5 mEq feeding
Calcium 15 mEq
Potassium 10 mEq
Chloride 7 mEq

PediaSure® Grow & Gain Protein 7 g Good source of fiber† to

with Fiber, Abbott Fat 9 g help maintain regularity.
Sat. Fat 1 g Excellent source of
Mono. Fat 6 g calcium, vitamin D, and
Cholesterol 5 mg phosphorus for strong
Carbohydrate 33 g bones.
Dietary fiber 3 g DHA (32 mg per 8 fl oz)
Total sugar 18 g and lutein to support the
Calories 240 kcal brain and eyes
Water 200 g

Kate Farms Pediatric Caloric Density 1.2 Tube feeding or

Standard 1.2, Kate Farms® calories/mL supplementation
Protein 16% Specifically developed for
Carbohydrate 48% ages 1 to 13 years
Fat 36%
Compleat® Pediatric, Caloric density - 1.0 Short or long term tube
Nestlé Health Science kcal/mL feeding regimen for those
Protein 15% who prefer a formula with
Carbohydrates 51% food ingredients
Fat 34% May help address feeding
intolerance common in
children with
developmental disabilities
Malnutrition
Support of normal growth

Compleat® Pediatric Caloric density 0.6 kcal/mL Short or long term tube
Reduced Calorie, Nestlé Protein 20 % feeding regimen for those
Health Science Carbohydrates 51% who prefer a formula with
Fat 29% food ingredients
May help address feeding
intolerance common in
children with
developmental disabilities
Reduced caloric needs
Support of normal growth
Bowel management

Polymeric; Concentrated Volume

Composition Formula brand Specifics Additional

name or details
Manufacturer

Milk based Boost® Kid Contains Soy Gluten-free,

EssentialsTM kosher, suitable
1.5, Nestlé for lactose
Health Science intolerance
Milk based Boost® Kid Contains Soy Gluten-free,
EssentialsTM 1.5 kosher, suitable
with Fiber, for lactose
Nestlé Health intolerance
Science

Milk protein Pediasure® 1.5 Contains Soy Gluten-free,

Cal, Abbott halal, kosher,
suitable for
lactose
intolerance

Milk and Soy PediaSure® 1.5 Contains Soy Gluten-free,

protein Cal with Fiber, halal, kosher,
Abbott suitable for
lactose
intolerance

FORMULA SPECIFICS INDICATION

Boost® Kid EssentialsTM 1.5, Calories 360 kcal Bowel Management

Nestlé Health Science Total Fat 18 g Inadequate Oral Intake
Sat. Fat 4 g Increased Energy Needs
Trans Fat 0 g Malnutrition
Cholesterol 10 mg Nutritionally appropriate
Sodium 180 g for ages 1 year and older
Total carbohydrate 41 g Shortened Feeding
Dietary fiber 2 g Schedules
Protein 10 g Volume Intolerance

Boost® Kid EssentialsTM 1.5 Calories 360 Bowel Management

with Fiber, Nestlé Health Total fat 18 g Inadequate Oral Intake
Science Sat. Fat 14 g Increased Energy Needs
Trans Fat 0 g Malnutrition
Cholesterol 10 mg Nutritionally appropriate
Sodium 180 g for ages 1 year and older
 Total carbohydrate 15 g Shortened Feeding
Dietary fiber 2 g Schedules
Protein 10 g Volume Intolerance

Pediasure® 1.5 Cal, Abbott Protein 9 g Excellent source of high-

Fat 9 g quality protein designed to
Sat fat 3.5 g meet the acceptable
Poly Fat 5 g macronutrient distribution
Mono Fat 7 g range of protein for
Carbs 38 g children 1 to 13 years of
Cholesterol 10 mg age.
Calories 350 kcal DHA (32 mg per 8 fl oz)
Sodium 90 mg and lutein to support the
Potassium 470 mg brain and eyes.
Calcium 330 mg Vitamin D, calcium and
phosphorus for strong
bones

Hydrolyzed; Standard volume

Composition Formula Brand Specifics Additional

Name, details
Manufacturer

Whey protein Peptamen Contains milk Gluten-free,

Junior®, Nestlé and soy kosher, suitable
Health Science ingredients for lactose
intolerance

Whey protein Peptamen Contains milk Gluten-free,

Junior® HP, and soy kosher, suitable
Nestlé Health ingredients for lactose
Science intolerance
Whey protein Peptamen Contains milk Gluten-free,
Junior® Fiber, and soy kosher, suitable
Nestlé Health ingredients for lactose
Science intolerance

Whey protein Peptamen Contains milk Gluten-free,

Junior® with and soy kosher, suitable
Prebio1TM , ingredients for lactose
Nestlé Health intolerance
Science

Whey protein, PediaSure® Gluten-free,

casein Peptide 1.0 halal, kosher,
Cal, Abbott suitable for
lactose
intolerance

Pea protein Kate Farms Vegan, no milk, Gluten-free,

Pediatric no soy, no suitable for
Peptide 1.0, gluten, no nuts, lactose
Kate Farms no corn intolerance

FORMULA SPECIFICS INDICATION

Peptamen Junior®, Nestlé Protein 12% Delayed gastric emptying

Health Science Carbohydrate 54% Chronic diarrhea
Fat 34% Short bowel syndrome
Pancreatic insufficiency

Peptamen Junior® HP, Caloric density 1.2 kcal/mL Impaired GI function (short
Nestlé Health Science Protein 16% bowel syndrome, cancer
Carbohydrate 50% cachexia, cerebral palsy,
Fat 34% Cystic fibrosis, Crhon’s
Sodium 6 mEq Disease, Malabsorption,
Calcium 18 mEq Chronic Diarrhea, delayed
Potassium 12 mEq gastric emptying, growth
Chloride 8 mEq failure, Malnutrition
Protein energy malnutrition
Critical Illness /trauma
Early enteral feeding
Transition from TPN

Peptamen Junior® Fiber, Caloric density 1.0 kcal/mL Impaired GI function (Short
Nestlé Health Science Protein 12% bowel syndrome, Cerebral
Carbohydrate 55% palsy, Cystic fibrosis,
Fat 33% Crohn’s disease,
Sodium 5 mEq Malabsorption, Chronic
Calcium 15 mEq diarrhea, Delayed gastric
Potassium 10 mEq emptying, Growth failure,
Chloride 7 mEq Malnutrition)

Early enteral feeding

Bowel management

Peptamen Junior® with Caloric density 1 cal/mL Gi impairment

Prebio1TM , Nestlé Health Protein 16% ● Malabsorption
Science Carbohydrate 49% ● Delayed gastric
Fat 35% emptying
● Diarrhea
● Short bowel
syndrome
● Cystic fibrosis
● Pancreatitis
Bowel function
Early enteral feeding
Transition from or dual
feeding with TPN
Kate Farms Pediatric Caloric density 1 cal/ml
● Dual therapy during
Peptide 1.0, Kate Farms Protein 14%
TPN or transition
Carbohydrates 48%
from TPN
Fat 38%
● Malabsorption
● Lactose-free,
vegan, plant-based,
gluten-free diets

Hydrolyzed; concentrated volume

Composition Formula Brand Specific Additional

Name, Details
Manufacturer

Whey Protein Peptamen Contains milk Gluten-free,

Junior® 1.5, and soy kosher, suitable
Nestlé Health ingredients for lactose
Science intolerance

Whey PediaSure® Gluten-free,

Protein/Casein Peptide 1.5 halal, kosher,
Cal, Abbott suitable for
lactose
intolerance
Organic Pea Kate Farms Vegan, no milk, Gluten-free,
protein Pediatric no soy, no suitable for
Peptide 1.5®, gluten, no nuts, lactose
Kate Farms® no corn intolerance

FORMULA SPECIFICS INDICATION

Peptamen Junior® 1.5, Caloric density 1.5 cal/mL ACBS approved,

Nestlé Health Science Protein 12% prescribable on FP10
Carbohydrate 48% (GP10 in Scotland).
Fats 40% Indicated as a sole source
of nutrition for children
aged 1-15 years for the
dietary management of
disease related
malnutrition in patients with
short bowel syndrome,
intractable malabsorption,
proven inflammatory
bowel disease, bowel
fistulae.

PediaSure® Peptide 1.5 Caloric density 1.5 cal/mL children 1-13 years with
Cal, Abbott Protein 12% malabsorption,
Carbohydrate 53% maldigestion, and other GI
Fat 35% conditions. It is designed to
meet the nutritional and
caloric needs of kids who
require higher caloric
density, have fluid
restrictions, and are at risk
for malnutrition. l For oral or
 tube feeding. l For
supplemental or sole-
source nutrition. l Use under
medical supervision

Kate Farms Pediatric Caloric density 1.5 cal/mL

Poor/limited volume
Peptide 1.5®, Kate Farms® Protein 14%
tolerance with need for a
Carbohydrate 44%
shortened feeding
Fat 42%
schedule

Allergy or intolerance to
milk, soy, corn, or artificial
sweeteners, flavors, colors,
or preservatives

Transition off a free amino

acid/elemental formula

Dual therapy during TPN or

transition from TPN

Malabsorption

Lactose-free, vegan, plant-

based, gluten-free diets

Elemental/Semi-Elemental

A.

Formula and indication kcal/scoop, gm/ scoop,

Macronutrients/ scoop
Magnesium,
Potassium,
Phosphorus,
Calcium Content
Preparation,
Caloric density,
and Flavor
EleCare® Jr, Abbott Kcal: 469kcal
Serving Size: 100g powder
Macro: 49.3g CHO, 14.3 CHON, 22.7g FAT,
Calcium: 543 mg
Magnesium: 74 mg
Phosphorus: 395 mg
- For the dietary management of Potassium: 706 mg
Sodium: 212 mg
protein maldigestion, malabsorption,
Preparation: To prepare Dilution of 30
severe food allergies, short-bowel
Cal/fl oz, 5fl oz with 4 scoops(38g)
syndrome, eosinophilic GI disorders,
Caloric Density: 4.69kcal/mL
GI-tract impairment, or other Flavor: Vanilla
conditions in which an amino acid-
based diet is required.

Alfamino® Infant, Nestlé Health Science Kcal: 100kcal

Serving Size: 5fl oz.
Macro: 11g CHO, 2.8 CHON, 5g FAT
Calcium: 119 mg
Magnesium: 9 mg
Phosphorus: 78 mg
- Appropriate for these diets: lactose Potassium: 100 mg
intolerance*, gluten-free *Not for Sodium: 40 mg
individuals with galactosemia Preparation: To prepare Add 1 unpacked
level scoop (4.7g) of powder for each 1 fl
oz water. (Only use an enclosed scoop.)
Caloric Density: 0.67kcal/mL
Flavor: Vanilla

Vivonex® Pediatric, Nestlé Health Science Kcal: 200kcal

Serving Size: 250mL
Macro: 32g CHO, 6g CHON, 5.8g FAT
Calcium: 280 mg
Magnesium: 50 mg
Phosphorus: 240 mg
- For severely impaired GI function: Potassium: 300 mg
Severe short bowel syndrome, Sodium: 100 mg
Malabsorption syndrome, GI Preparation:
trauma/surgery, Crohn's disease, Caloric Density: 0.8kcal/mL
Intestinal failure, Transition from TPN Flavor: unflavored
 and Burn injuries

Neocate® Junior: Nutricia Kcal: 100kcal

Serving Size: 400g
Macro: 10.7g CHO, 3.1g CHON, 5g FAT
Calcium: 118 mg
Magnesium: 16 mg
Phosphorus: 79.8 mg
Potassium: 136 mg
Sodium: 50 mg
- is specially formulated for the Preparation: Measure the required
dietary management of children amount of warm or cool water into a
with cow milk allergy (CMA), container. Add the prescribed amount of
multiple food allergies (MFA) and Neocate® Junior to the water.Stir, or
related GI and allergic conditions, cover and shake, until the powder has
including eosinophilic esophagitis dissolved. 4 fl oz., 4 scoops 29.2 with final
(EoE), food protein-induced volume of 4.7 fl oz.
enterocolitis syndrome (FPIES), short Caloric Density: 4kcal/mL
bowel syndrome (SBS), Flavor: Unflavored w/out probiotics,
malabsorption and Unflavored w/ probiotics, Vanilla,
gastroesophageal reflux (GER). Strawberry,

Modular Formula

FORMULA FEATURE SPECIFICS

Arginaid®, Nestle L-arginine (4.5

Health Science g/serving)

Argiment®, L-arginine (7.5 g)

Medtrition and L-glutamine (10
g)/serving (svg)
Complete Amino Essential and non-
Acid Mix, Nutricia essential amino
acids; 4.1 g/svg

Essential Amino Essential amino

Acid Mix, Nutricia acids

Single Amino Individual amino

Acids®, Nutricia acids; protien
content variable

XI. Types of Enteral Nutrition based on Disease Condition

B. Renal

Formula and indication kcal/scoop, gm/ scoop,

Macronutrients/ scoop
Magnesium,
Potassium,
Phosphorus,
Calcium Content
 Preparation,
Caloric density,
and Flavor

Abbot [Nepro HP] Kcal: 501 kcal per 100 g

Serving Size: per 100 ml
Macro: 43.5 g CHO, 21.6 g CHON, 25.6 Fat
Calcium: 282 mg
Magnesium: 56.1 mg
Phosphorus: 191 mg
Potassium: 282 mg
Sodium: 149 mg
This formula is for patients on dialysis and Preparation:
also suitable for malnourished, non- Caloric Density: 5.01 kcal/ml
dialyzed CKD patients with elevated Flavor: Vanilla
protein needs. It is for oral or tube
feeding.

Abbot [Nepro LP] Kcal: 504 kcal per 100 g

Serving Size: per 100 ml
Macro: 52.3 g CHO, 12.19 g CHON, 26.12
Fat
Calcium: 288 mg
Magnesium: 57 mg
Phosphorus: 195 mg
Potassium: 312 mg
Sodium: 171 mg
Nepro LP, on the other hand, is a formula
Preparation: Powdered form
for patients on non-dialysis CKD patients
Caloric Density: 5.04 kcal/ml
requiring a low protein diet and it is also
Flavor: Vanilla
for oral or tube feeding.

Nestle [Novasource® Renal] Kcal: 475kcal

Serving Size: per 237 mL
Macro: 43g CHO, 22g CHON, 24g FAT
Calcium: 200mg
Magnesium: 50mg
Phosphorus: 200mg
Potassium: 230mg
Novasource is a formula for patients with Sodium: 220mg
acute or chronic renal disease or those Preparation: Powder-form
needing electrolyte restriction. Caloric Density: 2 kcal/mL
Flavor: Vanilla

Fresenius Kabi [Fresubin® renal] Kcal: 400kcal

Serving Size: 200mL
Macro: 106g CHO, 6g CHON, 80g FAT
Calcium:
Magnesium:
Phosphorus:
Potassium:
Sodium:
Preparation: Ready to drink
For predialysis patients with chronic or
Caloric Density: 2.0kcal/mL
acute renal failure
Flavor: Tropical fruit

Kalbe [Nephrisol] Kcal: 260kcal

Serving Size: 4 scoops (61g)
Macro: 48g CHO, 5g CHON, 6g FAT
Calcium: 120g
Magnesium: 20mg
Phosphorus: 79 mg
Formulated to meet requirements for Potassium: 46mg
those with renal insufficiency, and help Sodium: 87 mg
delay CKD progression for patients on pre Preparation: Powder-form
dialysis stage Caloric Density: 1.04kcal/mL
Flavor: Vanilla

C. Diabetes

Formula and indication kcal/scoop, gm/ scoop,

Macronutrients/ scoop
Magnesium,
Potassium,
Phosphorus,
Calcium Content
Preparation,
Caloric density,
and Flavor

Diabetasol Kcal: 260 kcal

 Serving Size: per 60 g (4 tbsp)
Macro: 39 g CHO, 10 g CHON, 7 g Fat
Calcium:
Magnesium:
Phosphorus:
Potassium: 192 mg
Sodium: 90 mg
Preparation: Powder-form
Caloric Density: 4.3 kcal/g
Flavor: Vanilla & Chocolate

Glucerna SR Kcal: 266 kcal

Serving Size: per 52.6 g
Macro: 21.44 g CHO, 10.16 g CHON,
8.28 g Fat
Calcium: 168 mg
Magnesium: 59 mg
Phosphorus: 168 mg
Nutrition for people with diabetes
Potassium: 370 mg
Sodium: 211 mg
Preparation: Powder form
Caloric Density: 4.4 kcal/ml
Flavor: Vanilla

Nutren DIABPRO Kcal: 252 kcal

Serving Size: 55 g powder
Macro: 24.5 g CHO, 11.3 g CHON, 11 g
Fat
Calcium: 204 mg
Magnesium: 46 mg
Phosphorus: 138 mg
Potassium: 240 mg
For pre-diabetic patients, Sodium: 237 mg
management of DM type I & type II Preparation: Mix 55 g of powder in 210
patients, and GDM ml of water
Caloric Density: 4.6 kcal/ml
Flavor: Vanilla

Glucobest Kcal: 229 kcal

 Serving Size: 4 scoops (52g); 100mL
Macro: 29.6gCHO, 10g CHON 8.5g FAT
Calcium: 252mg
Magnesium: 103mg
Phosphorus: 138 mg
Potassium: 343mg
Sodium: 208mg
For Dietary Management of Protein-
Preparation: Powder-form
Energy Malnutrition associated with
Type II Diabete Caloric Density: 2.29kcal/mL
Flavor: Vanilla, Chocolate

D. Cancer (Catigbe)

Formula Formula content

Prosure Kcal: 33.36

Serving size: 220 ml
Macro: 5. 38g CHO - 1.76g CHON -
0.68g FAT
Calcium: 39.5 mg
Magnesium: 90.6 mg
Phosphorus: 336 mg
ProSure is an energy-dense, high Potassium: 53 mg
protein nutrition with EPA*, Sodium: 40 mg
specially designed for patients with Preparation: in 190 ml of water,
cancer-induced weight loss or add 9 level scoops of prosure
weight loss due to cancer therapy powder
Caloric Density: 1.3 kcal/g
Flavor: Vanilla, orange & banana

Oral Impact Kcal: 310 kcal

Serving Size: 74 g
 Macro: 42 g CHON - 17 g CHO - 7
g fat
Calcium: 185 mg
Magnesium: 37 mg
Phosphorus: 170 mg
Potassium: 318 mg
Sodium: 257 mg
Preparation: Powder-form
Caloric Density: 4.19 kcal/g
Flavor: Tropical Fruit Flavor
ORAL IMPACT® is used for the
dietary management of surgery
and malnutrition or at risk of
malnutrition in cancer patients.
ORAL IMPACT® contains
Immunonutrients: Arginine, Omega
3, Nucleotides.

Fresubin Kcal: 200 kcal

Serving Size: 200 ml
Macro: 27.6 g CHON - 7.6 g CHO -
6.8 g fat
Calcium: 120 mg
Magnesium: 40mg
Phosphorus: 94 mg
Potassium: 250 mg
Sodium: 150 mg
Preparation: Ready-to-drink
Caloric Density: 1 kcal/ml
Fresubin® Original Drink is a
Flavor: Vanilla
nutritionally complete 1kcal/ml oral
nutritional supplement, fiber free.
Clinically free from lactose, gluten
free. For the dietary management
of
patients with or at risk of disease-
related malnutrition.

Supportan Kcal: 300

Serving Size: 4 x 200 ml
 Macro: 24.8g CHO - 20g CHON -
13.4 g FAT
Calcium: 406 g
Magnesium: 26 mg
Phosphorus: 120 mg
Potassium: 256 mg
Sodium: 95 mg
Preparation: Ready to drink
Caloric Density: 1.5 kcal/ml
Flavor: Cappuccino & Tropical
Supportan® Drink is prescribable
fruits
on FP10/GP10 and intended for
the dietary management of
patients with pancreatic cancer
and patients with lung cancer
undergoing chemotherapy.

E. Lung Injury (Catigbe)

Formula and indication kcal/scoop, gm/ scoop,
Macronutrients/ scoop
Magnesium,
Potassium,
Phosphorus,
Calcium Content
Preparation,
Caloric density,
and Flavor

Oxepa Kcal: 759 kcal

Serving Size: 500 ml bottle
Macro: 14.05 g CHO - 8.35 g CHON - 27.6
g fat
Calcium: 530 mg
Magnesium: 212.5 mg
Phosphorus: 530 mg
Potassium: 980 mg
Sodium: 25.05 mg
Oxepa is a 1.5 kcal/ml tube feed
Preparation: Ready-to-hang
enriched with eicosapentaenoic acid
Caloric Density: 1.52 kcal/ml
(EPA), gamma linolenic acid (GLA) and
Flavor: Unflavored
antioxidants. It has been specifically
designed for the management of people
with Acute Lung Injury (ALI), Acute
Respiratory Distress Syndrome (ARDS),
and/or Systemic Inflammatory Response
Syndrome (SIRS). It is available in a 500 ml
Ready to Hang bottle, which attaches
directly to Abbott giving sets.
Nutren Pulmonary Kcal: 375 kcal
Serving Size: per 250 ml
Macro: 25g CHO - 17g CHON - 23.7g FAT
Calcium: 300 mg
Magnesium: 120 mg
Phosphorus: 300 mg
Potassium: 468 mg
Sodium: 292 mg
Preparation: ready to drink
Caloric Density: 1.5 kcal/ml
Nutren® Pulmonary is a complete liquid Flavor: Vanilla
nutrition formulated for people with
chronic respiratory disease. NUTREN®
PULMONARY has a carbohydrate and fat
profile to help reduce carbon dioxide
production. Can be used as a tube
feeding or oral supplement.

Pulmocare Kcal: 1500 kcal

Serving Size: 1 Liter container
Macro: 105.7 g- 62.6g- 93.3g
Calcium: 1060 mg
Magnesium: 425 mg
Phosphorus: 1060 mg
Potassium: 1780 mg
Sodium: 1310 mg
Preparation: Ready to hang
Caloric Density: 1.5 kcal/ml
PULMOCARE is designed for people with
Flavor: Vanilla
chronic obstructive pulmonary disease
(COPD), cystic fibrosis, or respiratory
failure who may benefit from a high-
calorie, modified carbohydrate and fat
enteral formula that may help reduce
diet-induced carbon dioxide production.
For tube or oral feeding. For supplemental
or sole-source nutrition. Use under
medical supervision.
XII. PRODUCT ALGORITHM (SUMMARY)
XIII. REFERENCES
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