Formula entering

Specialized enteral formulas may have a role in carefully selected patients... 

Approximately what should be the goal rate for this patient using this enteral formula ... 

Occluded feeding tube lumen Insoluble complexation of enteral formula and medication(s) Inadequate flushing of feeding tube Undissolved feeding formula... 

Infectious complications of EN include aspiration pneumonia and infections related to delivery of contaminated EN formula. Aspiration is a complication with GI, mechanical, and infectious implications. Although GI infections owing to contamination of enteral formulas have been reported uncommonly, there is ample opportunity for these formulas to be seeded with organisms during the processes of transferring from the can to the delivery bag with ready-to-use formulas and during the process of reconstitution with powdered formulas. The so-called closed systems of delivery, wherein the formulas come from the manufacturer premixed in a delivery bag, should help to decrease the chance of formula contamination. 

Essential fatty acid deficiency is rare but can occur with prolonged lipid-free parenteral nutrition, very low fat enteral formulas, severe fat malabsorption, or severe malnutrition. The body can synthesize all fatty acids except for linoleic and linolenic acid, which should constitute approximately 2% to 4% of total calorie intake. 

Castillo, G., Angeles Sanz, M., Angeles Serrano, M. and Hernandez, A. (2002). Influence of protein source, type and concentration and product form on the protein quality of commercial enteral formulas, J. Food Sci., 67, 1, 328-334. 

Rufian-Henares, J. A., Guerra-Hernandez, E. and Garcia-Villanova, B. (2002). Maillard reaction in enteral formula processing furosine, loss of o-phthaldial-dehyde reactivity and fluorescence. Food Res. Inti., 35, 527-533. 

Corneau, L., Lavigne, C., and Zee, J. A. (1996). Effect of calcium and zinc concentrations and calcium source on in vitro calcium and zinc solubility in a fiber-fortified enteral formula. Nutr. Res. 16,1659-1669. 

If you plan to use spreadsheets in this course, you should know how to enter formulas in a spreadsheet and how to draw a graph of data in a spreadsheet. 

The concentration of furosine in some enteral formulae has been determined, ranging from 245 to 441 mg per 100 g protein.40 It seems to decrease on further processing and does not appear to be a useful indicator of quality. Furosine content seems to be stable in enteral formulae on storage for >36 weeks at 4 °C, 24 weeks at 20 °C, and >12 weeks at 30 °C.41 Stability at 55 °C was down to 3-8 weeks, depending on protein content, whereafter furosine content declined. Reactivity of lysine residues with ophthaldialdehyde declined roughly in parallel with furosine formation. 

J. A. Rufian-Henares, Garcia-Villanova, and E. Guerra-Hemandez, Furosine content, loss of o-phthalaldehyde reactivity, fluorescence and colour in stored enteral formula, Int. J. Dairy Techn., 2002, 55, 121-126. 

Enter the values in the first six columns of the first row of the 12-column table (1, 50,..., 45) and enter formulas in the next six columns (including Ctot = Crefr + C comp)-... 

Enter formulas for the two partial pressures (use Raoult s law) and for their sum. and then enter a formula for y. 

Inevitably, your worksheet formulas will at times contain errors. Earlier in this chapter you learned some of the ways to prevent or discover errors while entering formulas. But even if a formula is syntactically correct, it may produce an error when it is evaluated. This section provides some techniques and tips for tracking down errors in your spreadsheets. 

From the set of differential equations, enter formulas in spreadsheet cells using Euler s method, Fill Down and make sure that the results make sense. 

Guar gum is a low-viscosity water-soluble dietary fiber that has been used to treat diabetes because it slows the absorption of glucose from the gut. However, adverse effects such as regurgitation, obstipation, abdominal cramps, diarrhea, and itching are common (1). Partially hydrolysed guar gum has been added to enteral formulas and food products as a source of dietary fiber it can reduce laxative use, diarrhea in septic patients receiving total enteral nutrition, and symptoms of irritable bowel sjmdrome (2). 

Tributyl citrate is used to plasticize polymers in formulated pharmaceutical coatings. The coating applications include capsules, tablets, beads, and granules for taste masking, immediate release, sustained-release, and enteric formula-... 

In constructing this spreadsheet, we have learned some of the basics of spreadsheet operation, including typing text into a spreadsheet, changing column widths with the mouse, duplicating cells with the fill handle, and entering formulas into a spreadsheet. 

As a final exercise, retrieve the spreadsheet that we created in Chapter 3 for the gravimetric determination of chloride, which we called grav chloride.xls. Enter formulas into cells B12—B14 to compute the mean, standard deviation, and the RSD in parts per thousand of the percent chloride in the samples. In this example, multiply the relative standard deviation by 1000 in cell B14. Adjust the decimal point in the results to display the proper number of significant figures. The worksheet below shows the results. Save your worksheet so that you can use it as a model for making laboratory calculations. 

Barton RG. Immune-enhancing enteral formulas Are they beneficial in critically ill patients. Nutr Clin Pract 1997 12 51-62. 

The macronutrient content of enteral formulas (namely, protein, carbohydrate, and fat) varies in nutrient complexity (Table 138-6). Nutrient complexity refers to the amount of hydrolysis and digestion... 

When a feeding tube is inserted nasally or orally, there is a risk that the tube may inadvertently enter the tracheobronchial tree. The risk may be higher in patients who have an impaired cough or gag reflex and when a stylet is used for tube insertion. Proper positioning of the tube should always be confirmed by x-ray prior to feeding initiation to avoid inadvertent administration of enteral formula into the lung. 

Mixing liquid medications with certain enteral feeding formulations has been associated with several types of physical incompatibilities including granulation, gel formation, separation, and precipitation. Not only can these physical incompatibilities inhibit drug absorption, gel formation potentially may clog small-bore enteral feeding tubes. Physical incompatibility with medications is more common in formulations that contain intact protein than in those with hydrolyzed protein. Also, medication and enteral formula incompatibilities are more common with the use of acidic pharmaceutical syrups. The most prudent recommendation is to avoid the routine admixture whenever possible, especially for nonaqueous preparations and syrups. In the... 

When a patient is fed with carbohydrates, the amount of carbon dioxide produced markedly exceeds the amount of oxygen consumed in comparison to proteins and fats, which can result in increased ventilatory demand in patients with pulmonary disease. Therefore higher-fat enteral formulas should be considered for use in these patients and overfeeding should be avoided. 

CKD and ESKD patients who require nutritional support rarely need PN because their GIT usually is functional. The caloricahy dense low-electrolyte enteral formulas (see Table 139-1) are particularly... 

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