Hospitalized patients receiving parenteral nutrition and supplemental enteral nutrition formulas: clinical outcomes of interest

Aims; This study assessed the clinical and economic effects of incorporating supplementary enteral nutrition formulas (ENFs) alongside parenteral nutrition in malnourished patients who are hospitalised. The study aimed to ascertain the clinical ramifications of these interventions.

Methods: A study at King Hussein Medical Centre analyzed malnourished patients who received one of six tested enteral nutritional formulas and parenteral nutritional supplementation. The study included adult and elderly hospitalized patients, with exclusion criteria for missing more than 5% of data. Four nutritional cohorts were evaluated: those without supplemental enteral nutrition formulas, regular ENFs, specialized modular ENFs, and modular protein formulae. The study examined variations in albumin levels during hospitalization and modifications in the composite predictive ratio of C-reactive protein to albumin. The study also examined clinical outcomes like total hospital length of stay, mortality, gastrointestinal symptoms, and enteric gram-negative bacteria translocation.

Results: The study analyzed the distribution rates of enteral nutritional adjunctive formulas in patients with hypoalbuminemic conditions. It found no significant differences in distribution rates or average estimations across the six tested formulas. The highest average albumin level changes were observed in patients receiving ArgiMent as the standard enteral nutritional provision. The study also showed significant variations in hospital stay and overall fatality rate over 28 days. The cost expenditure for increasing albumin levels was lowest in patients using arginine/glutamine-based formulas. The study also found significant differences in gastrointestinal tolerances, with the highest incidence of intolerance symptoms in Group IV. The incidence of enterobacteriaceae positive cultures was minimal in glutamine and arginine-based formulas.

Conclusion: In conclusion, administering trophic doses of enteral feeding formulas to hospitalised patients dependent on total parenteral nutrition and exhibiting hypoalbuminemia may yield substantial clinical and economic advantages, especially if the enteral nutrition formulas are characterised by enhanced nutritional properties, including high protein density, glutamate, zinc, and prebiotic enrichments.