22 May 2013
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Guidelines for the Use of Immuno Nutritive Formula
Last Update: 07 Jan 2012 10:55 AM
Guidelines for the Use of Immuno Nutritive Formula    
  
  • Purpose
    To define the criteria and guidelines that should be met for a patient to be managed on Immuno Nutritive rich formula.
  • Definitions
    Immuno nutritive formula – a formula containing nutrients that enhances the immune system. Impact Formula – is an enteral product containing arginine, omega 3 fatty acids, and glutamine and as such can be defined as Immuno nutritive formula. Its appropriate use is necessary to achieve desirable outcomes. It is not the product to be utilized for all patients requiring enteral nutrition.
  • Policy statements
    All Clinical Dietitians must follow the criteria when to recommend the Immuno nutritive formula for the patient.
  • Procedures
    • The Clinical Dietitian should do nutritional assessment if the patient is in need of Immuno nutritive rich formula.
    • Indications for the use of Immuno nutritive formula:
    • Patients undergoing major elective GI surgery, trauma, (abdominal trauma index scores >20), burns (total body surface area >30%), head and neck cancer, and critically ill patients on mechanical ventilation (who are not severely septic).
    • Contraindications
      • Severe sepsis (Refer to ASPEN Guidelines 2009)
      • Immuno suppressive therapy
    • In order to achieve the desired outcome, it is essential to ensure that the feeding regimen meets the following guidelines:
      • Pre-operative feeding: Minimum of 5-7 days prior to surgery
    • Post-operative feeding: Should be commenced as soon as possible preferably within the first 24 hours.
  • Equipment / forms Electronic system – Quadramed for referral
  • Related references
    • Gianotti et al Gastroenterology 2002: 122: 1763-1770
    • Braga et al Arch Surg 2002; 137 – 180
    • Stechmiller et al Am J Crit Care 2004 3(1) 17-23
  • Appendices
    [All related documents that must be included with this DPP for immediate reference.]    

 

   
     
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