Nutrihep is the brand name of a low protein, low sodium enteral feeding formula for use in patients with liver disease. These patients typically suffer from encephalopathy and the large percentage of branched chain amino acides decreases physiological on the liver and causes less mental status derangements. It is lactose and gluten-free and kosher.

It is a high density calorie source of feeding to minimize the required amount of fluids that need to be administered. It is a low The protein source in Nutrihep is 66% branched chain amino acids and 33% long chain amino acids. The carbohydrate source is maltodextrin and modified cornstarch . The fat sources are medium chain triglycerides, corn oil, canola oil, and lecithin.

Nutrihep can be taken orally (it can be flavored) or given via any feeding tube.

About 1000 ml/day are needed to meet the recommended RDI (required daily intake) of micronutrients

Dietary fiber – 0 g/L
Cals/mL – 1.5
Proteins – 10.6 %
Carbohydrate – 77.3%
Fats – 12.7%
Total cals/nitrogen – 234:1

Sodium/L – 13.9 mEq
Potassium/L – 33.8 mEq
Chloride/L – 42.4 mEq
Phosphorus/L – 1000 mg
Magnesium/L – 376 mg
Calcium/L – 956 mg

Iron/L – 18 mg
Vitamin K/L – 120 mcg

Vivonex is the brand name of an enteral feeding formula used in patients with metabolic stress such as sepsis, systemic inflammatory response syndrome (SIRS) or with a malabsorptive condition. It is considered an-elemental formula because the protein source is completely hydrolyzed. It is lactose and gluten-free and kosher.

The protein sources in Vivonex is free amino acids. The carbohydrate sources are maltodextrin and modified starch . The fat source is soybean oil.

Vivonex is given via feeding tube. It is generally not administered to a goal rate, but rather is used to start a feeding regimen and then is converted to a semi-elemental formula when the patient has improved. Generally, patients with an albumin < 2.5 mg/dl should receive an elemental or semi-elemental feeding formula.

About 1420 ml/day are needed to meet the recommended RDI (required daily intake) for key vitamins and nutrients. The formulation is as follows:

Dietary fiber – none
Cals/mL – 1.0

Sodium/L – 29 mEq
Potassium/L – 20 mEq
Chloride/L – 23 mEq
Phosphorus/L – 670 mg
Magnesium/L – 270 mg
Calcium/L – 670 mg

Iron/L – 12 mg
Vitamin K/L – 53 mcg

Optimental is the brand name of an enteral feeding formula used in patients with metabolic stress such as sepsis, systemic inflammatory response syndrome (SIRS) or with a malabsorptive condition. It is considered a semi-elemental formula in that a portion of the protein source is partially hydrolyzed for better absorption while the rest is the form of free amino acids. It is lactose and gluten-free and kosher.

The protein sources in Optimental are soy protein hydrolysate, partially hydrolyzed sodium caseinate, and free arginine. The carbohydrate sources are maltodextrin, sucrose, and fructooligosaccharides (FOS) . The fat source contains medium chain triglyerides, canola oil, and soybean oil.

Optimental is given via feeding tube or can be drunk by the patient. It is generally not administered to a goal rate, but rather is used to start a feeding regimen and then is converted to a polymeric feeding formula when the patient has improved

About 1420 ml/day are needed to meet the recommended RDI (required daily intake) for key vitamins and nutrients. The formulation is as follows:

Dietary fiber – 5 g/L
Cals/mL – 1.0
Proteins – 20 %
Carbohydrate – 4%
Fats – 25%
Total cals/nitrogen – 122:1

Sodium/L – 46 mEq
Potassium/L – 45 mEq
Chloride/L – 38 mEq
Phosphorus/L – 1055 mg
Magnesium/L – 425 mg
Calcium/L – 1060 mg

Iron/L – 13 mg
Vitamin K/L – 85 mcg

Nepro is the brand name of an enteral feeding formula for use in kidney dialysis patients, particularyly intermittent dialysis. These patients typically require restriction in fluids and electrolytes. It is lactose and gluten-free and kosher.

It is a high calorie source of feeding and serum glucose levels must be carefully monitored, particularly in patient with diabetes. The protein source in Nepro is calcium, sodium, and magnesium caseinates. The carbohydrate source is corn syrup, sucrose, and fructooligosaccharides (FOS) . The fat source is high oleic safflower, canola oil, and lecithin.

Nepro can be taken orally (i.e., drunk by the patient) or given via any feeding tube. It is available in vanilla, cherry supreme, and butter pecan.

Nepro is supplemented with the essential fatty acids L-carnitine and taurine and is absent molybdenum and chromium as these are thought to accumulate in dialysis patients

About 950 ml/day are needed to meet the recommended RDI (required daily intake.)

Dietary fiber – 15.6 g/L
Cals/mL – 1.8
Proteins – 18 %
Carbohydrate – 34%
Fats – 48%
Total cals/nitrogen – 139:1

Sodium/L – 46.1 mEq
Potassium/L – 27.1 mEq
Chloride/L – 23.9 mEq
Phosphorus/L – 700 mg
Magnesium/L – 210 mg
Calcium/L – 1060 mg

Iron/L – 19 mg
Vitamin K/L – 85 mcg

Jevity Plus is the brand name of an enteral (i.e., via the gut) feeding solution that is widely used in surgical patients for nutrition. Jevity Plus is also known as Jevity 1.2.

It is one of the formulas that is recommended for long -term tube feedings and can be given via a nasogastric tube, orogastric tube, gastrostomy tube, PEG tube, and surgically placed jejunostomy tube.

Jevity Plus gets its protein source from sodium and calcium caseinates, carbohydrates from corn syrup and maltodextrin fiber, and it’s fat source from high oleic safflower oil, canola oil, lecithin, and medium chain triglycerides

It contains no lactose or gluten and is considered isotonic and is generally well-tolerated by patients with relatively normal gut, liver, and kidney function who can not take oral nutrition by mouth (e.g., severely head injured patients). It takes about 1 L/day to meet the required RDI (recomended daily intake.)

Characteristics of its formulation include:

Dietary fiber – 18-22 g/L
Cals/mL – 1.2
Proteins – 18.5%
Carbohydrate – 52.5%
Fats – 29%
Total cals/nitrogen – 135:1

Sodium/L – 58.7 mEq
Potassium/L – 47.4 mEq
Chloride/L – 42.4 mEq
Phosphorus/L – 1200 mg
Magnesium/L – 400 mg
Calcium/L – 1200 mg

Iron/L – 18 mg
Vitamin K/L – 80 mcg

Osmolarity/K H20 – 450 mosm