Peptamen TUBE FEEDING INTOLERANCE | PROTEIN DELIVERY | BLOOD GLUCOSE | PEPTAMEN® PRODUCTS | EDUCATION PEPTAMEN® products are supported by over 25 years of clinical experience and more than 60 published studies. PEPTAMEN® formulas are the only enteral nutrition formulas with 100% whey protein, available in a range of protein concentrations to facilitate: Tolerance and absorption Protein delivery to achieve protein targets and support muscle protein synthesis Blood glucose management PEPTAMEN® FORMULAS ARE THE #1 RECOMMENDATION BY CANADIAN DIETITIANS for adults experiencing enteral nutrition intolerance* *to standard polymeric tube feeding formulas† † Enteral Nutrition Intolerance Brand Recommendation Claims Study conducted on behalf of Nestlé Health Science, May 2019 PEPTAMEN® HAS A UNIQUE PROTEIN PROFILE Protein Source PEPTAMEN® formulas are the only enteral nutrition formulas with 100% whey protein. Whey protein has multiple attributes, which can support gastrointestinal tolerance, muscle protein synthesis, and blood glucose management. Protein Form PEPTAMEN® contains hydrolyzed whey protein (<1% intact protein). Small protein units or peptides facilitate digestion and absorption to help with tolerance. Protein Amount PEPTAMEN® family of products offer a range of protein levels to meet different nutritional needs. Facilitates delivery of protein targets. TUBE FEEDING INTOLERANCE 35–65% of tube fed patients experience intolerance in Canada1 Tube feeding or enteral nutrition (EN) intolerance is reported to affect patient quality of life and to reduce EN volume delivered – which may result in nutrition deficits, dehydration and malnutrition.2 PEPTAMEN® is designed for tolerance and absorption: • 100% whey protein remains liquid in an acidic environment to help facilitate gastric emptying and reduce reflux3-6 • Small protein units, with <1% intact protein, enhance absorption7-9 • Lipid blends with 50–70% MCT enhance fat absorption10-13 What are some symptoms of tube feeding intolerance? Symptoms of intolerance may include, but are not limited to, the following: Nausea Bloating Diarrhea Constipation CLICK HERE for PEPTAMEN® and Managing Intolerance Infographic Watch a short video showing how PEPTAMEN® has been specially formulated for people with gastrointestinal impairment or tube feeding intolerance. RESOURCES VIDEOS Enteral Nutrition Intolerance Beyond the ICU Janet Madill, PhD, RD Enteral nutrition intolerance (ENI) or tube feeding intolerance has been reported as the most common complication associated with tube feeding. This Canadian study examines the prevalence and management of ENI in patients and individuals outside the ICU. A Nurse’s Guide to Minimizing Tube Feed Intolerance Alice Atcher, BSc, RN, CCRN, CRNI The benefits of early tube feeding in the ICU, barriers that may impede the delivery of early and adequate nutrition, and strategies to help minimize enteral feeding intolerance – presented from a nursing perspective. STUDY SUMMARY Prevalence and Management of Enteral Nutrition Intolerance in the Non-ICU Setting in Canada Hopkins B et al. CJCN. 2017; 5(2): 82-101. Enteral nutrition (EN) intolerance, described as one or more gastrointestinal (GI) symptoms, is reported to affect patient quality of life and reduce EN volume delivered, which may result in nutrition deficits, dehydration and malnutrition. This study examines the prevalence and management of EN intolerance outside of the ICU setting. MATERIALS/TOOLS Tube Feeding Intolerance – Troubleshooting Guide Use the checklist to help determine if your patient may be experiencing tube feeding intolerance and to track severity and duration of symptoms. Refer to the Troubleshooting Guide for solutions to consider for managing intolerance symptoms. Your Guide to Home Tube Feeding Patient information about managing tube feeding at home. This guide is intended to support the tube feeding advice and instruction provided by healthcare professionals. PEPTAMEN® Starter Booklet Information for the patient/family on why nutrition is important and specific considerations for individuals with gastrointestinal impairment. This booklet also contains information about how PEPTAMEN® is designed for gastrointestinal tolerance and absorption – in tube feeding or oral use. PROTEIN DELIVERY Patients may present with a number of conditions, which may lead to higher protein needs. When a combination of these factors exists, it can have a profound influence on the protein needs of patients. WHEY PROTEIN CAN HELP COUNTERACT MUSCLE LOSS.14,18 Adequate delivery of protein is important to optimize functional and clinical outcomes in patients with muscle loss related to age or muscle wasting associated with illness.14-17 PEPTAMEN® facilitates delivery of protein: • Protein Quality: Contains 100% whey protein, which is high in leucine to support muscle protein synthesis • Protein Quantity: Range of products available, including high protein formulas: ⟩ PEPTAMEN® AF 1.2 (25% calories from protein) ⟩ PEPTAMEN® INTENSE 1.0 HP (37% calories from protein) RESOURCES VIDEO Protein in Critical Illness: An RD Perspective Michele ApSimon, RD, MSc This presentation provides an overview of protein needs and protein metabolism in the context of the critically ill patient. Practical tips and considerations for clinical nutrition practice in the ICU are discussed, drawing on case examples and clinical experience. STUDY SUMMARIES The International Protein Summit Recommendations Hurt R et al. Nutrition in Clinical Practice. 2017;32(S1):142-151S. Global experts in clinical nutrition and protein metabolism provide expert consensus opinion on provision of protein in the intensive care unit (ICU) and to help close the gap between what is happening in clinical practice and what is recommended by nutrition society guidelines. Achieving Protein Targets in the ICU With a Specialized Enteral Formula Hopkins B & Alberda C. Can J of Diet Pract Res. 2016;77(3):e1. Abstract. A quality improvement study in Canadian ICUs showed PEPTAMEN® INTENSE 1.0 HP (enteral formula with 37% calories from protein) will deliver at least 80% prescribed protein needs in the ICU. BLOOD GLUCOSE MANAGEMENT Whey protein has insulinotropic effects and has been shown to reduce postprandial glycemia in patients with acute and chronic hyperglycemia.19 Use of PEPTAMEN® INTENSE 1.0 HP as an enteral nutrition formula in the ICU can help: • Facilitate blood glucose management in ICU patients20,21 • Reduce the frequency of insulin administrations to ICU patients compared to standard enteral nutrition formula20 RESOURCES VIDEO Glucose Management in the ICU: The Evolving Role of Nutrition Todd Rice MD, MSc Hyperglycemia is prevalent in the ICU and is associated with poor outcomes. The traditional treatment is insulin, but its use increases risk of hypoglycemia. New evidence suggests using a high protein, hypocaloric enteral formula with nutrients that have insulinotropic properties may help with blood glucose management and reduce frequency of insulin administered. STUDY SUMMARY Dietary Management of Blood Glucose in Medical Critically Ill Overweight and Obese Patients: An Open‑Label Randomized Trial Rice T, Clark Files D, Morris PE, Bernard A, Ziegler T, Drover JU, Kress J, Hamm K, Grathwohl D, Huhmann M, Ochoa Gautier J. Journal of Parenteral and Enteral Nutrition. DOI:10.1002/jpen.1447. Hyperglycemia is prevalent in the ICU and is associated with poor outcomes. Use of a very high protein (37%), enzymatically hydrolyzed 100% whey protein, low CHO (29%) enteral nutrition formula was related to decreased hyperglycemic events and insulin administration in critically ill overweight/obese ICU patients. PEPTAMEN® PRODUCTS PEPTAMEN® 1.0 View product PEPTAMEN® 1.0 with Prebio1™ View product PEPTAMEN® 1.5 View product PEPTAMEN® AF 1.2 View product PEPTAMEN® INTENSE 1.0 HP View product PEPTAMEN® Product Guide For information on all Nestlé Health Science products: Nestlé Health Science Product Guide REFERENCES 1. Hopkins B et al. CJCN. 2017;5(2):82-101. 2. Bernard AC et al. NCP. 2004;19:481-486. 3. Fried MD et al. J Pediatr. 1992;120:569-72. 4. Khoshoo V et al. Eur J Clin Nutr. 2002;56:1-3. 5. Dangin M et al. J of Nutr. 2002;S3228-33. 6. Abrahao V. Curr Opin Clin Nutr Metab Care. 2012;15:480-484. 7. Grimble GK. Annu Rev Nutr. 1994;14:419-47. 8. Hannelore D. Annu Rev Physiol. 2004;66:361-84. 9. Maples B. JPEN. 2005;29:51. 10. Malone A et al. in Mueller C (Ed). 2012. Core Curr ASPEN. 11. Martindale R et al. in Gottschlich M (Ed). 2007. Core Curr ASPEN. 12. Hise M & Brown J. in Mueller C (Ed). 2012. Core Curr ASPEN. 13. Colaizzo-Anas T. in Mueller C (Ed). 2012. Core Curr ASPEN. 14. Little JP & Phillips SM. Appl Physiol Nutr Metab. 2009;34:817-828. 15. Moisey LL et al. Critical Care. 2013;17:R206. 16. Cruz-Jentoft AJ et al. Age and Ageing. 2010:1-12. 17. Fearon K et al. J Cachexia Sarcopenia Muscle. 2011;2:1-3. 18. Breen L & Phillips SM. Nutr & Metab. 2011;8(68):e-version. 19. Adams RL & Broughton KS. Ann Nutr Metab. 2016;69:56-63. 20. Ochoa JB et al. JPEN. 2017;41(2):289. 21. McClave SA et al. JPEN. 2015;39(2):240. nestle-monitoring-loaded TO ENSURE WE ARE DELIVERING YOU THE APPROPRIATE CONTENT, PLEASE CONFIRM: I AM A HEALTH CARE PROFESSIONAL I AM NOT A HEALTH CARE PROFESSIONAL You are being redirected. For more information, please speak with your healthcare professional