Osmolality of modified enteral tube feeds for adults in hospitals across the Western Cape Province
Objectives: The first aim of this study was to determine the incidence of use, reasons for use, and procedures/recipes followed in modifying enteral tube feeds (ETFs) for adults in state and private hospitals across the Western Cape Province (WCP), South Africa (baseline data). The second aim was to determine the osmolality of the modified ETFs used by these hospitals (osmolality data). Design: A descriptive cross-sectional study. Setting and subjects: The study was conducted in January/February 2007. The baseline data was collected by means of a coded questionnaire sent to all state and private hospitals in the WCP (n = 111), excluding all children's hospitals. The osmolality data was obtained by means of freeze-point depression of the modified ETF recipes obtained from the participating hospitals. Results: A total response rate of 94% was obtained. Of the participating hospitals (n = 104), 48% were state (n = 50) and 52% were private hospitals (n = 54). Sixty-two per cent of hospitals (n = 64) made use of ETFs, with 25% modifying their feeds (n = 16). Twelve recipes were obtained for the osmolality testing. Eight recipes (66%) were significantly lower (p < 0.001), two (16%) were significantly higher (p < 0.001) and two of the recipes did not differ from the standard enteral product. Eight recipes (66%) had a significantly higher average osmolality (p < 0.001) than that of body fluid. The concentrated ETF recipe (1.43 kcal/ml) had the highest osmolality (707 mOsm/kg/H20). Conclusions: Modular ETFs had lower average osmolality than those of the semi-modular and the standard enteral products, and of body fluid (300 mOsm/kg/H20).