Composition of enteral nutrition formulations available for use in Intensive Care Units of Brazilian hospitals: an observational study

Authors

  • Jéssica Viana Hinkelmann Programa de Pós-graduação em Saúde, Universidade Federal de Juiz de Fora, Minas Gerais, Brasil. https://orcid.org/0000-0002-8385-2510
  • Ana Paula Boroni Moreira Faculdade de Nutrição, Universidade Federal de Juiz de Fora, Minas Gerais, Brasil. https://orcid.org/0000-0001-5909-1996
  • Júlia D`Almeida Francisquini Faculdade de Farmácia, Universidade Federal de Juiz de Fora, Minas Gerais, Brasil.
  • Ítalo Tuler Perrone Faculdade de Farmácia, Universidade Federal de Juiz de Fora, Minas Gerais, Brasil.
  • Rodrigo Stephani Departamento de Química, Universidade Federal de Juiz de Fora, Minas Gerais, Brasil.
  • Sheila Cristina Potente Dutra Luquetti Faculdade de Nutrição, Universidade Federal de Juiz de Fora, Minas Gerais, Brasil. https://orcid.org/0000-0002-2257-5337

Keywords:

Enteral Nutrition, Nutrition Therapy, Intensive Care Units, Critical care

Abstract

Introduction: Critically ill patients present clinical and metabolic changes, and enteral nutrition therapy is an integral part of treatment, with formulations of diverse compositions available on the market. Objective: To analyze the nutritional composition of closed-system enteral nutrition formulations available for use in Brazilian Intensive Care Units. Methods: This is a cross-sectional, observational, and descriptive study. We performed a composition analysis of labels/portfolios of enteral nutrition in a closed system from the three main brands supplying to Brazil, to obtain data such as the quantity and source of macronutrients, and compliance to international and national recommendations about the quantity of micronutrients. Pearson correlation, ANOVA and Kruskal-Wallis were conducted with SPSS software version 23.0. Results: Forty-two enteral nutrition formulations were analyzed. All samples provided micronutrient levels recommended by Brazilian legislation, except for vitamin D. Maltodextrin was the main carbohydrate source, and glucose syrup was present in five samples. Fiber was present in 57%, with a predominance of soluble fibers. Calcium caseinate was the main protein source, and only 21.4% of the samples had a blend of animal and plant-based proteins. Sunflower and canola oils were the main lipid sources, and 61.9% of the formulations contained fish oil. Conclusion: Enteral nutrition composition can influence gastrointestinal tolerance, immune and inflammatory response, the prevention of malnutrition and ICU-acquired weakness.

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References

Tedeschi-Jockers F, Reinhold S, Hollinger A, Tuchscherer D, Kiss C, Gantner L, et al. A new high protein-to-energy enteral formula with a whey protein hydrolysate to achieve protein targets in critically ill patients: a prospective observational tolerability study. Eur J Clin Nutr. 2022; 76:419–27. DOI: 10.1038/s41430-021-00956-9.

Kaspy MS, Hannaian SJ, Bell ZW, Churchward-Venne TA. The effects of branched-chain amino acids on muscle protein synthesis, muscle protein breakdown and associated molecular signalling responses in humans: an update. Nutr Res Rev. 2023; 1–14. DOI: 10.1017/S0954422423000197.

FAO/WHO/UNU. Protein and amino acid requirements in human nutrition. Report of a Joint FAO/WHO/UNU Expert Consultation; 2007 [Internet]. Geneva: World Health Organization; [cited 2026 May 13]. (WHO Technical Report Series, No. 935). Available at: https://iris.who.int/server/api/core/bitstreams/b7c5ec43-bc59-4b38-b702-3f0e96a06fa1/content.

Watanabe S, Tsujino S. Applications of Medium-Chain Triglycerides in Foods. Front Nutr. 2022; 9:802-5. DOI: 10.3389/fnut.2022.802805.

Moon GK, Bu SY. Effects of omega-3 fatty acid supplementation on skeletal muscle mass and strength in adults: a systematic review. Clin Nutr Res. 2023; 12:304. DOI: 10.7762/cnr.2023.12.4.304.

Trumbo P, Schlicker S, Yates AA, Poos M. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. J Am Diet Assoc. 2002; 102:1621–30. DOI: 10.1016/S0002-8223(02)90346-9.

Calder PC, Adolph M, Deutz NE, Grau T, Innes JC, Klek S, et al. Lipids in the intensive care unit: recommendations from the ESPEN Expert Group. Clin Nutr. 2018;37:1–18. DOI: 10.1016/j.clnu.2017.08.032.

Stoppe C, Martindale RG, Klek S, Calder PC, Wischmeyer PE, Patel JJ. The role of lipid emulsions containing omega-3 fatty acids for medical and surgical critical care patients. Crit Care. 2024; 28:271. DOI: 10.1186/s13054-024-05053-4.

Breik L, Tatucu-Babet OA, Paul E, Duke G, Elliott A, Ridley EJ, et al Micronutrient intake from enteral nutrition in critically ill adult patients: A retrospective observational study. Nutrition. 2022; 95:111543. DOI: 10.1016/j.nut.2021.111543.

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Published

2026-05-26

How to Cite

1.
Hinkelmann JV, Moreira APB, Francisquini JD, Perrone Ítalo T, Stephani R, Potente Dutra Luquetti SC. Composition of enteral nutrition formulations available for use in Intensive Care Units of Brazilian hospitals: an observational study. HU Rev [Internet]. 2026May26 [cited 2026May30];51:1-10. Available from: https://periodicos.ufjf.br/index.php/hurevista/article/view/51464

Issue

Vol. 51 (2025)

Section

Artigos Originais

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Copyright (c) 2026 Jéssica Viana Hinkelmann, Ana Paula Boroni Moreira, Júlia D`Almeida Francisquini, Ítalo Tuler Perrone, Rodrigo Stephani, Sheila Cristina Potente Dutra Luquetti

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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