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Viscosity Thickened Enteral Formula

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Diet and Nutrition in Critical Care

Abstract

Thickened enteral formula (TEF) is a formula in which viscosity is intentionally increased by adding thickener to prevent enteral nutrition-related complications, such as diarrhea, nausea, vomiting, and gastroesophageal reflux (GER). Three types of TEFs are available at present: intragastric TEF, TEF prepared by mixing liquid enteral formula and thickener, and ready-to-use type. The positive effects of TEF are considered to be based on its high viscosity, which reduces the outflow rate of gastric contents and thereby helps to prevent diarrhea and GER. While several studies have been conducted on TEF with viscosity ranging from 900 to 20,000 mPa · s, the mechanisms of TEF have not been fully demonstrated. TEF efficacy with regard to reducing complications of EN should not be determined based solely on quantitative viscosity data, as modalities for measuring viscosity and assessing complications subsequent to administration have not been standardized. Potential advantages of TEF include prevention of GER, diarrhea, skin trouble around the percutaneous endoscopic gastrostomy puncture site, and improvement of blood glucose levels and quality of life for both patients and caregivers. However, most previous studies of TEF have been empirical in nature, with little scientific evidence available supporting the efficacy of TEF in preventing complications of EN. TEF administration is only successful when functions of gastric motility, enterokinesis, digestion, and absorption are all normal. When applying TEF, bacterial contamination, feeding tube shape, timing and volume of administered water, and nutrient interactions should be considered. Given the present findings, TEF appears more suitable for use in patients in long-term care hospitals, nursing homes, or home medical care settings than acute care hospitals. Establishing a solid base of evidence supporting the usage of TEF will require more large-scale randomized controlled trials.

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Abbreviations

EN:

Enteral nutrition

GER:

Gastroesophageal reflux

IG:

Intragastric

LT:

Liquid and thickener

PEG:

Percutaneous endoscopic gastrostomy

QOL:

Quality of life

RTU:

Ready to use

TEF:

Thickened enteral formula

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Author information

Authors and Affiliations

  1. Department of Nutrition Management, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, 650-0047, Kobe, Hyogo, Japan

    Satomi Ichimaru

  2. Department of Food Science and Nutrition, School of Human Environmental Sciences, Mukogawa Women’s University, 6-46 Ikebiraki, 663-8558, Nishinomiya, Japan

    Teruyoshi Amagai

Authors
  1. Satomi Ichimaru
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  2. Teruyoshi Amagai
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Corresponding author

Correspondence to Satomi Ichimaru .

Editor information

Editors and Affiliations

  1. Royal Free London Hospitals, Barnet General Hospital, London, UK

    Rajkumar Rajendram

  2. Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK

    Rajkumar Rajendram

  3. King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia

    Rajkumar Rajendram

  4. Department of Nutrition and Dietetics, Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK

    Victor R. Preedy

  5. Department of Biomedical Sciences, Faculty of Science & Technology, University of Westminster, London, UK

    Vinood B. Patel

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Ichimaru, S., Amagai, T. (2015). Viscosity Thickened Enteral Formula. In: Rajendram, R., Preedy, V.R., Patel, V.B. (eds) Diet and Nutrition in Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7836-2_27

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  • DOI: https://doi.org/10.1007/978-1-4614-7836-2_27

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-7837-9

  • Online ISBN: 978-1-4614-7836-2

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