What is the recommended daily feeding volume of Jevity (peptide-based nutrition supplement) 1.2 Cal for a 143-pound patient with a Gastrostomy (G) tube?

Enteral Nutrition Dosing for 143-Pound Patient via G-Tube

For a 143-pound (65 kg) patient receiving Jevity 1.2 Cal through a gastrostomy tube, provide 1300-1625 mL daily (1560-1950 kcal/day) to meet standard nutritional requirements of 25-30 kcal/kg/day. 1

Caloric and Protein Requirements

• Target energy: 25-30 kcal/kg/day based on actual body weight 1, 2

  • For 65 kg patient: 1625-1950 kcal/day
  • With Jevity 1.2 Cal (1.2 kcal/mL): approximately 1350-1625 mL/day

• Target protein: 1.0-1.5 g/kg/day 1

  • For 65 kg patient: 65-98 grams protein daily
  • Jevity 1.2 Cal provides adequate protein density to meet these requirements at the prescribed volume

• Minimum safe threshold: 1500 kcal/day ensures adequate micronutrient provision when using complete enteral formulas 3

Initiation and Advancement Protocol

Start conservatively and advance systematically:

• Begin continuous feeding at 10-20 mL/hour 3, 4
• Advance by 10-20 mL increments every 12-24 hours based on tolerance 3
• Target rate over 3-4 days: 55-70 mL/hour continuous (to deliver 1320-1680 mL over 24 hours) 2
• Alternatively, if using bolus feeding via G-tube: divide total daily volume into 4-6 feedings of 220-270 mL each

Critical point: Reach 70-80% of caloric goals and 100% of protein goals within the first few days, as protein targets may be more important than energy goals early in therapy 2

Administration Guidelines

• Patient positioning: Maintain head of bed at ≥30° elevation during feeding and for 30 minutes after to minimize aspiration risk 3
• Delivery method: Continuous pump feeding preferred initially; may transition to bolus feeding once tolerance established
• Feeding schedule: Avoid nocturnal-only feeding if aspiration risk exists; extend feeding hours into early evening while patient remains upright 4

Monitoring Requirements

During initial feeding period:

• Check gastric residuals every 4 hours initially; hold feeding if residuals exceed 200 mL 3
• Monitor for intolerance signs: abdominal distension, nausea, vomiting, diarrhea 3
• Weekly assessment of weight, serum albumin, and nutritional parameters 3
• Blood glucose monitoring if diabetic or at risk for refeeding syndrome 2

Common Pitfalls and Management

Diarrhea during tube feeding:

• Antibiotic use is the strongest predictor of diarrhea (41% incidence with antibiotics vs 3% without) 5
• Low serum albumin (<2.5 g/dL) increases diarrhea risk 5
• Jevity contains fiber (14.4 g/L soy polysaccharide), which may reduce diarrhea incidence compared to fiber-free formulas 5
• If diarrhea develops: reduce feeding rate temporarily rather than stopping entirely; consider Clostridium difficile testing if on antibiotics 4, 5

Bezoar prevention:

• Ensure semi-recumbent positioning during feeds 6
• Consider proton pump inhibitor if patient has gastroesophageal reflux, mechanical ventilation, or neurological disease 6
• Flush tube with 30-50 mL water before and after each feeding

Special Considerations

For patients requiring lower volumes:

• If energy needs are reduced (e.g., immobile, overweight patients), minimum 1000-1200 mL/day may be appropriate 7
• Below 1500 kcal/day, monitor for micronutrient deficiencies and consider supplementation 3

For post-surgical or malnourished patients:

• May require higher protein targets (1.2-1.6 g/kg/day) 3
• Consider supplemental overnight feeding via G-tube (500-1000 kcal) if oral intake inadequate 1

Long-term management:

• Regular reassessment of nutritional status during hospitalization and after discharge 1
• Qualified dietary counseling for patients continuing tube feeding at home 1
• Monitor for weight loss patterns, particularly in post-gastrointestinal surgery patients who may lose 5-12% body weight over 6 months despite nutritional support 1