Folwarski Marcin, Kłęk Stanisław, Zoubek-Wójcik Agata, Szafrański Waldemar, Bartoszewska Lidia, Figuła Krzysztof, Jakubczyk Marlena, Jurczuk Anna, Kamocki Zbigniew, Kowalczyk Tomasz, Kwella Bogna, Matras Przemysław, Sonsala-Wołczyk Joanna, Szopiński Jacek, Urbanowicz Krystyna, Zmarzły Anna
Department of Clinical Nutrition and Dietetics, Medical University of Gdańsk, Gdańsk, Poland.
Home Enteral and Parenteral Nutrition Unit, Department of General Surgery, Nicolaus Copernicus Hospital, Gdańsk, Poland.
Front Nutr. 2022 Jul 7;9:906186. doi: 10.3389/fnut.2022.906186. eCollection 2022.
Enteral nutrition (EN) with foods for special medical purposes (FSMP) is recommended for most patients on home enteral nutrition (HEN). Although there are disease-specific guidelines for energy, protein, and micronutrient provision, only a few studies are showing real-life experience in the long-term use of FSMP.
In a multicenter study, the influence of the FSMP composition and administration technique (bolus vs. continuous) on protein and energy provision in HEN was analyzed. Provision of vitamins and minerals was compared to recommended daily allowance (RDA) and upper tolerable limit (UL).
Approximately, 772 patients on HEN, mostly (88.6%) with oncological and neurological diseases, were enrolled. The patients on standard FSMP received less protein and energy than those on hypercaloric and protein enriched despite receiving higher volumes of EN ( < ). No differences were observed in jejunal feeding with oligomeric vs. polymeric FSMP in terms of energy, protein, and volume. Continuous gastric feeding provided more protein, energy, and volume vs. bolus feeding ( < ). Significant number of patients received less than 100% RDA of vitamin D (50.5%), vitamin B3 (49%), vitamin K (21.8%), vitamin B5 (64.3%), vitamin B9 (60%). Majority of the patients received less than 100% RDA of sodium (80.2%), potassium (99%), chloride (98%), calcium (67%), magnesium (87%), fluoride (99%), and iodine (43%). Approximately, 43.63% of cancer and 49.9% of neurological patients received less than 1 g/kg/day of protein and 51.7% of cancer and 55.5% of neurological patients received less than 25 kcal/kg/day.
Awareness of the available compositions of FSMP and advantageous profiles of specific diets may lead to the implementation of recommendations for EN. HEN professionals need to analyze all the patient's needs and requirements to provide more tailored matching of nutritional support.
对于大多数接受家庭肠内营养（HEN）的患者，推荐使用特殊医学用途食品（FSMP）进行肠内营养（EN）。尽管有针对能量、蛋白质和微量营养素供应的特定疾病指南，但仅有少数研究展示了FSMP长期使用的实际经验。
在一项多中心研究中，分析了FSMP的成分和给药技术（推注与持续输注）对HEN中蛋白质和能量供应的影响。将维生素和矿物质的供应与推荐每日摄入量（RDA）和可耐受最高摄入量（UL）进行比较。
约772例接受HEN的患者入组，其中大多数（88.6%）患有肿瘤和神经系统疾病。尽管接受的肠内营养量更大，但接受标准FSMP的患者比接受高热量和高蛋白强化FSMP的患者摄入的蛋白质和能量更少（<）。在能量、蛋白质和摄入量方面，空肠喂养低聚型与多聚型FSMP未观察到差异。与推注喂养相比，持续胃内喂养提供了更多的蛋白质、能量和摄入量（<）。大量患者维生素D（50.5%）、维生素B3（49%）、维生素K（21.8%）、维生素B5（64.3%）、维生素B9（60%）的摄入量低于RDA的100%。大多数患者钠（80.2%）、钾（99%）、氯（98%）、钙（67%）、镁（87%）、氟（99%）和碘（43%）的摄入量低于RDA的100%。约43.63%的癌症患者和49.9%的神经系统疾病患者蛋白质摄入量低于1 g/kg/天，51.7%的癌症患者和55.5%的神经系统疾病患者能量摄入量低于25 kcal/kg/天。
了解FSMP的可用成分和特定饮食的优势特征可能有助于实施肠内营养建议。HEN专业人员需要分析患者的所有需求，以提供更具针对性的营养支持匹配方案。
