Open AccessNecessidade de módulo proteico para pacientes em estado grave: estudo das fórmulas enterais em sistema fechado disponíveis no mercado
Author(s) -
José Henrique Silvah,
Carolina Ferreira Nicoletti,
Cristiane Maria Mártires de Lima,
Arthur Welle,
Júlio Sérgio Marchini
Publication year - 2020
Publication title -
braspen journal
Language(s) - English
Resource type - Journals
eISSN - 2764-1546
pISSN - 2525-7374
DOI - 10.37111/braspenj.2020352005
Subject(s) - calorie , enteral administration , medicine , energy requirement , parenteral nutrition , obesity , mathematics , statistics , regression
The nutritional support of critically ill patients must be individualized and meet thedaily energy and protein needs. Despite the fact that health entities publish their respective nutritionaltherapy recommendations for these patients, guidelines on the use of protein modules are still scarceand controversial. This study aimed to evaluate the protein / energy adequacy of the industrializedenteral formulas existing in the Brazilian market used in the nutritional therapy of adult patients, aswell as the need to use protein modules. Methods: 46 enteral formulas found in the Brazilian marketwere evaluated, by means of mathematical simulations, in relation to the adequacy against proteinrecommendations, without extrapolating the energy supply (limit of 110% of the daily requirement). Forthe simulations, comprising the protein module, the energy supply of the module was included in theanalysis. Results: The protein / calorie ratio varied between 3.1 and 9.2. For patients without obesity,only the Peptamen Intense - Nestlé formula [protein ratio (g)/100 kcal = 9.2] reaches at least 100% ofthe protein requirement (1.5 to 2g protein/kg/day), with a volume calculated to 20 to 25 kcal/kg. Forpatients with BMI between 30 and 36 kg/m2, there is no formula that achieves the recommendation inisolation. The Peptamen Intense - Nestlé formula meets the recommendations for patients with a BMIbetween 36 and 40 and a BMI> 44 kg/m2. The comparison of the Peptamen Intense - Nestlé formulawith the rest of the formulas available on the market plus protein module shows that Fresubin 2 kcalHP - Fresenius needs the lowest volume of the set (enteral formula + protein module) to reach 1000kcal and 92 g of protein (25.5% less than Peptamen Intense - Nestlé). Conclusion: Most of the enteralformulas available in the Brazilian market are not able to offer, in isolation, an adequate protein supply,without generating excess energy supply (overfeeding). The use of protein modules can bring benefitsto the recovery of patients, including those infected by COVID-19.