Osmolality and pH in handmade enteral diets used in domiciliary enteral nutritional therapy

Abstract Patients who need prolonged domiciliary enteral nutritional therapy may benefit from handmade diets. However, the preparation of such diets might cause insecurity with regard to their nutritional composition and physical-chemical properties. Current study analyzes the osmolality and Hydrogen-Ion concentration (pH) on handmade enteral diets. To this purpose, six formulas and two juices, prescribed on discharge from hospital, were analyzed physically and chemically. Osmolality and pH were respectively determined by cryoscopy and potentiometry. Most formulations were classified as isosmolar (with less than 400 mOsm/kg solvent), and only one was classified as slightly hyperosmolar, with rates ranging from 356.7 to 403.5 mOsm/kg solvent. On average, the standard formula presented higher osmolality than similar ones prepared for hyperglycemia. Among the juices, only one registered hyperosmolar concentration of 595.54 mOsm/kg solvent. All formulas presented pH rates classified as low acidity, ranging between 6.1 and 6.6, while the two juices had the lowest results, 4.73 and 4.66 each. The blend of ingredients used in handmade formulas and juices studied presented acceptable osmolality and pH rates for a safe administration and absence of gastrointestinal complications. Data showed here are consistent with an appropriate and healthy diet and contributed towards success in domiciliary enteral nutritional therapy.

摘要：需要长期居家肠内营养治疗的患者，可从自制肠内膳食中获益。但此类膳食的制备过程，可能使其营养组成与理化特性存在安全性隐患。本研究针对自制肠内膳食的渗透压（osmolality）与氢离子浓度（pH，Hydrogen-Ion concentration）展开分析。为此，本研究对6种出院带用的处方肠内制剂与2种果汁开展理化分析。渗透压与pH分别通过冰点降低法与电位测定法进行检测。多数制剂被归类为等渗（渗透压低于400 mOsm/kg溶剂），仅1种为轻度高渗，渗透压范围为356.7至403.5 mOsm/kg溶剂。平均而言，标准配方的渗透压高于针对高血糖患者制备的同类配方。在所有果汁中，仅1种的渗透压达高渗水平，为595.54 mOsm/kg溶剂。所有肠内制剂的pH值均呈低酸性，范围为6.1至6.6；而两种果汁的pH值更低，分别为4.73与4.66。本研究涉及的自制肠内制剂与果汁的配料组合，其渗透压与pH值均处于安全给药、不会引发胃肠道并发症的可接受范围内。本研究所得数据符合健康适宜膳食的标准，可为居家肠内营养治疗的成功开展提供支持。