Friday, February 15, 2019

elemental formula

Q: Predigested enteral nutrition (elemental) tube feed formula typically has all of the following characteristics except

A) short-chain peptides 
B) decreased total fat 
C) decreased medium-chain triglycerides 
D) beneficial in chylothorax 
E) no difference in mortality

Answer: C

There are two objectives of the above question.

One, to re-emphasize that elemental formula is beneficial in chylothorax (choice D) as it has increased medium-chain triglycerides (choice C). Medium-chain triglycerides tend not to enter the lymphatic capillaries in the small intestine. 

Second, Despite some advantages in mal-absorptive situation, predigested formulas failed to show any decrease in mortality, infectious complications, or the incidence of diarrhea. (choice E is correct).



1. McClave SA, Taylor BE, Martindale RG, et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr 2016; 40:159. 

2. Seres DS, Ippolito PR. Pilot study evaluating the efficacy, tolerance and safety of a peptide-based enteral formula versus a high protein enteral formula in multiple ICU settings (medical, surgical, cardiothoracic). Clin Nutr 2017; 36:706.

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