In my years of working in the ICU, I can say that I have one favorite type of tube feeding that I find to be a real work horse. This type of tube feeding covers many needs for the patients I deal with, including; high calorie/protein ratio, low osmolarity and easily tolerated. Many of the patients I work with are obese (many with BMI’s over 35, 40 and even 50) and are diabetic. Many of these patients are also on ventilator support and require propofol for sedation. Often, these patients are receiving well over 500 calories per day from propofol, so overfeeding of total calories and meeting protein needs is difficult to avoid, except usually with this tube feeding type.
I am speaking, of course, of tube feedings such as Vital HP or Peptamin VHP. I do not hold one over the other and have used both with the same benefits. I use this for many patients, not only the obese on propofol, but also medical patients on pressor support, new gi surgical patients who are just starting enteral feeds and any patient with high protein needs, including renal patients (whether on CRRT, HD or AKI) What I am mainly looking for is the protein needed and these types of formulas usually fit the bill.
I would suggest always having a product like this on your formulary because of its versatility and easy tolerance. During the years of covid, it was almost the only formula we used during the acute phase (ventilator phase) of illness. As patients progressed, the formulas were changed to more basic formulas such as Osmolite 1.5 (again, not supporting to use these specific formulas, Isosource 1.5 is the same in my experiences).
Anyway, I am still getting to know how to use this website, so bear with me. I will try to post something every few weeks, fingers crossed!
