The use of calorically dense enteral formulas in adult home enteral nutrition population in a tertiary care center: A retrospective analysis

Introduction: The prevalence of home enteral nutrition (HEN) has increased dramatically as studies showing clinical benefit have emerged. During this time, the practice of HEN has evolved as well including the availability of diverse formulas ranging in macronutrient distribution and concentration. Despite this availability, there continues to be a paucity of data regarding the efficacy of 2.0 kcal/ml density formulas in the HEN population. Materials and Methods: A retrospective review of HEN database was conducted for the use of concentrated formula (2.0 kcal/ml). Baseline variables as well as efficacy of formula were assessed. Results: In the time period evaluated, 32 HEN patients with a mean age of 58 ± 13.4 years met inclusion criteria. A total of 25 (78.1%) patients were male, the most common indication for HEN was dysphagia (53.1%), and the most common diagnosis was head-and-neck cancer (65.7%). The vast majority (87.4%) received concentrated formula through percutaneous gastrostomy (PEG) and were able to receive 93.1% ±19.7% of their goal calories needs as well as 98.5% ±21.7% of their goal protein needs. A total of 9 (28%) patients were initially started on concentrated formula, whereas 23 (72%) were switched from their initial formula with most common indication being the need for additional calories. Twenty-nine patients (90.6%) were able to utilize the formula as their primary source of nutrition with 22 patients (69%) reported no adverse effects. Conclusions: Our study found that the use of concentrated formula was well tolerated in a diverse cohort of patients, meeting their calorie and protein needs. The following core competencies are addressed in this article: Medical knowledge, Practice-based learning, Systems-based practice.