The clinical impacts of early trophic feeding using protein formulas in compared with standard formulas in intolerated enteral nutrition hospitalized patients

Abstract EN

Objectives: Patients who are not taking any enteral feeding may decrease the integrity of enterocytes which subsequently increase risk of bacterial translocation.

The aim of this study is to compare the clinical and economic impacts of early trophic feeding using standard enteral nutritional formulas, reconstituted whey protein, and ArgiMent® at rate of 10 ml every hour and 20 ml every 2 hours in intolerated enteral feeding hospitalized patients in terms of albumin level, cost effectiveness ratio, overall hospital length of stay and mortality.

Methods: We conducted a retrospective analysis of 326 patients admitted to our King Hussein Medical Hospital between Apr 2017 to Mar 2019 who were their demographics, diagnostics, anthropometrics, and required lab data were known.

Analysis values were compared among the six tested groups by using ANOVA for continuous variables and Chi square test for nominal data after exclusion all hospitalized patients who were discharged or died before completed at least 2 weeks after admission.

Results: The mean overall age was 58.37±9.95 years.

224 participants (68.7%) were male and 102 participants (31.3%) were female.

The percentage changes in albumin level was significantly highest (38.1%±2.45%) and the hospital length of stay, mortality, risk of enteric pathogen translocation were significantly lowest (9.0±0.00 days, 4 (7.5%), and 4 (7.4%), respectively) in patients who were on ArgiMent® followed by patients who were on reconstituted whey protein and standard enteral nutritional formulas.

Despite of ArgiMent® highest daily trophic feeding cost (10.8±0.00 USD), ArgiMent® had the highest cost-effectiveness to increase the albumin level by 1 g/dl.

Conclusion: In summary, using early trophic feeding at rate of either 10 ml per hour or 20 ml per 2 hours for 16 hours per day of any enteral formulas may have positive clinical and economic outcomes with acceptable GIT tolerance especially if the enteral feeding have higher glutamine, leucine, protein density, and caloric density.