When having a patient recieving enteral nutrition we reduce the fluid from the IV line of the 24 hour. But do we need to substract the total of the enteral feeding of the total fluids even thought the enteral feed is not a whole sum of fluid because there are solutes, and i sometimes have to go and talk to the nutrition department that the increase the enteral load to fast on a critical patient that needs the IV line for fluid intake regarding specific cases?
Enteral Feeds have 0.7 to 0.8 mL water per mL of the feed, so, it is important the IV Fluids & Enteral feeding have to be counted, especially in renal, cardiac and Peds. to ensure the right fluid balance. Also, don't forget to count the water flushes given when medication or other Enteral Modulars are to be given via the Enteral Tube.
Ok, According to A.S.P.E.N guideline in determination of required fluid in ml/ day by multiply % water in formula times daily formula in mL to determine water contribution of EN.
Subtract formula water from total fluid requirements to determine water flushes.
For example,
Patient needs 2200 ml fluid
2000 ml formula * 84% water = 1680 ml
So, 2200 - 1680 = 520 ml of additional water ( by IV or medication dilution).
Yo estimo que no se puede despreciar en la estimación del balance hídrico el contenido de "agua metabólica" presente en los nutrientes hidrocarbonados y grasos contenidos en la nutrición enteral. Visto así, el componente acuoso pude rebasar los 0,9 ml de agua por ml de la alimentación.
this link is useful
gut.bmj.com › Archive › Volume 52, Issue suppl 7
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