Jevity Tube Feeding Administration Rate Guidelines
For Jevity tube feeding at 1.2 to 1.5 concentration, it is recommended to start at a low flow rate of 10-20 ml/hour and increase gradually over 5-7 days to reach the target rate due to limited intestinal tolerance. 1
Initial Administration Protocol
- Start tube feeding with a low flow rate of 10-20 ml/hour to prevent complications related to feeding intolerance 1
- For jejunal feeding (post-pyloric), continuous pump-assisted administration is essential to prevent dumping syndrome as it bypasses the stomach reservoir 2
- Increase the rate gradually and individually based on patient tolerance, with the understanding that reaching target rates may take 5-7 days 1
Rate Progression Guidelines
For Adults:
- Initial rate: 10-20 ml/hour 1
- Increase by 10-15 ml/8 hours based on tolerance 1
- Target rate should be calculated based on nutritional requirements and the energy density of Jevity (1.2 or 1.5 kcal/ml) 1
For Continuous Feeding:
- Adults: Start at 30-50 ml/hour and gradually increase to target rate over several days 1
- Continuous pump-assisted feeding is preferred for critically ill patients to prevent enteral nutrition-related complications 3
Monitoring Protocol
- Check for signs of feeding intolerance: abdominal distension, nausea, vomiting, and diarrhea 4
- Position patient at 30° or more during feeding and for 30 minutes after to minimize aspiration risk 4
- For gastric feeding, check gastric residuals every 4 hours initially; if aspirates exceed 200 ml, review feeding policy 4
- Monitor for diarrhea, which occurs in approximately 30% of tube-fed patients and is often associated with antibiotic use rather than the feed itself 5
Special Considerations
- For malnourished patients, monitor closely for refeeding syndrome, particularly when initiating feeding 4
- For patients with diarrhea, consider reducing the feeding rate temporarily rather than stopping the feeding entirely 2
- Avoid nocturnal feeding in patients at risk of aspiration; instead, extend feeding hours into early evening while the patient remains upright 2
- For jejunal feeding, maintain continuous rather than bolus administration to prevent dumping syndrome 2
Common Pitfalls and How to Avoid Them
- Tube clogging: Use standard enteral formulas rather than kitchen-made (blenderized) diets, which have higher risk of clogging 1
- Feeding intolerance: Starting at too high a rate can cause dumping syndrome, diarrhea, or abdominal discomfort; always start low and increase gradually 1
- Medication interactions: Some medications may precipitate when mixed with enteral formulas; administer medications separately when possible 6
- Inadequate nutrition: Monitor nutritional parameters regularly to ensure adequate nutrition despite potential feeding interruptions 2
By following these guidelines, you can safely administer Jevity tube feeding at 1.2 to 1.5 concentration while minimizing complications and ensuring optimal nutritional support.