High Nitrogen Elemental Diet
Indications And Clinical Uses: A high nitrogen, elemental (100% free amino acids) diet for patients with impaired digestion and absorption. Contains enhanced glutamine, arginine and branched chain amino acid content, especially useful in stressed catabolic patients. Suggested indications include: inflammatory bowel disease, intestinal atresia, pancreatitis, fistula, partial obstruction, short-gut syndrome. Malnutrition and cachexia. Bowel preparation prior to diagnostic and surgical procedures. Transition diet between parenteral and normal oral feeding. Food sensitivities.
Precautions: Do not administer parenterally. For use only under medical supervision. Nausea, vomiting, abdominal cramps, distention and diarrhea are possible. Nausea and diarrhea are usually due to feeding rate or diet concentration. Local water conditions may be implicated in instances of diarrhea. Preparing diet with deionized or distilled water may be effective in this circumstance.
Aspiration is an uncommon complication. However, radiologically confirm the anatomic position of the feeding tube, elevate head of the bed 30° while the patient is receiving diet intragastrically, and control the administration to 150 mL/hour or less, depending upon patient tolerance. Jejunal administration should also be considered.
Diabetics and patients with renal insufficiency receiving this diet should be closely monitored. Use in children may require adjusting the daily consumption to meet the Recommended Daily Allowance for the age group involved.
Dosage And Administration: 1 800 mL or 7 520 kJ (6 servings or 1 800 kcal) provides at least 100% of the Canadian RNI (adult males, 25 to 49) for protein and essential vitamins and minerals. May be administered by nasogastric, nasointestinal, esophagostomy, gastrostomy or jejunostomy feeding tube.
Oral: For oral use, the product should be flavored and chilled over ice. Flavoring agents may be used if their contribution to the elemental and nutritional qualities of the diet are kept in mind. It should be sipped slowly, preferably through a straw, when served as a beverage.
Vivonex Plus is a perishable liquid food when in solution. A full day’s supply may be prepared at one time and stored in the refrigerator for up to 48 hours, shake the liquid before serving. Do not leave at room temperature for more than 8 hours.
Availability And Storage: Each 79.5 g packet contains: ¹-D maltodextrin, L-glutamine, modified cornstarch, L-leucine, L-arginine acetate, soybean oil, L-lysine acetate, magnesium gluconate, L-isoleucine, L-valine, calcium glycerophosphate, L-phenylalanine, L-threonine, potassium citrate, L-cysteine HCl monohydrate, citric acid, L-methionine, L-tyrosine, L-histidine monohydrochloride monohydrate, L-aspartic acid, L-proline, sodium citrate, sodium phosphate dibasic, L-tryptophan, potassium chloride, choline bitartrate, L-serine, L-alanine, glycine, ascorbic acid, potassium sorbate, polyglycerol esters of fatty acids, L-carnitine, taurine, zinc sulfate, niacinamide, ferrous sulfate, alpha tocopheryl acetate, D-calcium pantothenate, BHA/BHT (to preserve freshness), alpha tocopherol (to preserve freshness), copper gluconate, pyridoxine HCl, manganese sulfate, vitamin A palmitate, riboflavin, thiamine HCl, folic acid, biotin, chromic acetate, potassium iodide, sodium molybdate, sodium selenite, phytonadione (vitamin K1), cyanocobalamin (vitamin B12), cholecalciferol (vitamin D3).
The standard dilution of 4.2 kJ (1 kcal)/mL has a pH of approximately 5.0 and an average osmolality of 650 mOsm/kg. Pouches of 79.5 g, cartons of 6, cases of 6 cartons. Store unopened powder below 30°C.
VIVONEX® PLUS Novartis Nutrition High Nitrogen Elemental Diet