Indications And Clinical Uses: A high nitrogen, elemental (100% free amino acids) diet enriched with glutamine for patients with impaired digestion or absorption. 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: 2 000 mL or 8 360 kJ (6.7 servings or 2 000 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 T.E.N. 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 80 g packet contains: ¹-D maltodextrin, modified cornstarch, L-leucine, L-glutamine, L-arginine acetate, magnesium gluconate, L-valine, L-isoleucine, calcium glycerophosphate, safflower oil, L-lysine acetate, L-aspartic acid, L-alanine, L-phenylalanine, L-proline, glycine, L-threonine, L-methionine, L-histidine monohydrochloride monohydrate, potassium chloride, L-serine, L-tryptophan, sodium phosphate dibasic, potassium sorbate, sodium citrate, potassium citrate, L-tyrosine, ascorbic acid, choline bitartrate, ferrous gluconate, polyoxyethylene sorbitan monooleate, taurine, L-carnitine, niacinamide, zinc sulfate, alpha tocopheryl acetate, D-calcium pantothenate, ascorbyl palmitate (to preserve freshness) manganese glycerophosphate, alpha tocopherol (to preserve freshness), pyridoxine HCl, riboflavin phosphate sodium salt, cupric citrate, vitamin A palmitate, thiamine HCl, folic acid, BHA/BHT (to preserve freshness), biotin, sodium selenite, potassium iodide, sodium molybdate, chromic acetate, phytonadione (vitamin K1), cyanocobalamin (vitamin B12), cholecalciferol (vitamin D3).
The standard dilution of 4.2 kJ (1 kcal)/mL has a pH of approximately 5.3 and an average osmolality of 630 mOsm/kg. Cases of 6 cartons with 10 pouches of 80 g. Store unopened powder below 30°C.
VIVONEX® T.E.N. Novartis Nutrition Elemental Diet