(P08-015-23) Utilization of Disease-Specific Formulas in Enteral Nutrition Therapy: A Retrospective Descriptive Analysis

Objectives: Enteral nutrition (EN) serves as a means of nutrient provision for those not able to take in sufficient amounts orally. Standard polymeric formulations (SPF) vary in macronutrient composition and ingredient profile, while disease-specific formulas are available to fit the needs of certain patient populations. There is a paucity of data regarding the utilization of these formulas across clinical settings.

Methods: A retrospective review of EMR of patients who received disease-specific formula between January and June 2019.

Results: A total of 86 patients were included (mean age 60.9 ± 14.3 y; 64% male, mean BMI 30.2 ± 8.7) who were placed on a disease-specific formulas (renal 92% and hepatic 8%). No diabetic-specific formula was used. These formulas were utilized exclusively in inpatient settings: 80.2% in critical care and 19.8% in non-critical care for a median of 13 days (IQR 4—26). Admission diagnoses were noted including acute cardiac events 33.8%, sepsis/septic shock 23.3%, respiratory failure 11.6%, renal injury 5.8%, cerebrovascular accident 5.8%, decompensated liver diseases 5.8%, and other 8.1%. Comorbidities were prevalent in our cohort including chronic kidney disease 44.2%, hypertension 38.3%, diabetes mellitus 34.8%, atherosclerotic cardiovascular disease 33.7, liver disease 7%, and COPD/sleep apnea 7%. Twenty-one patients (24.4%) had a history of cancer.

A renal formula was indicated primarily for kidney injury requiring renal replacement therapy 51.9%. Other indications include fluid restriction 24% and electrolytes disturbance 24.1%. Hepatic formula was indicated for refractory hepatic encephalopathy/insufficiency 100%.

On average, the estimated daily calorie requirement was 1668.3 ± 396.9 kcal (92.3% ± 16.3 met by EN). Oral autonomy was achieved by 46.5%, while 22.1% transitioned to SPF, 1.2% transitioned to parenteral nutrition, 23.3% died to their underlying conditions, and data on end point was insufficient in 6.9%.

Conclusions: The disease-specific formulas in this review were most prevalent among the critically ill to mitigate electrolyte derangement and hepatic insufficiency, and not utilized beyond the inpatient setting. The necessity for these formulas should be actively assessed, and further investigation should be done to observe continued impact on respective disease states.

Funding Sources: N/A