Nutritional Content of 48 oz Daily Jevity 1.5
A 48‑oz (1,420 mL) daily volume of Jevity 1.5 kcal/mL enteral formula delivers approximately 2,130 kcal, 85 g protein, 1,207 mL free water, and complete micronutrient coverage for an 84‑year‑old, 68 kg postoperative patient on gastrostomy feeding.
Energy and Macronutrient Delivery
Total calories: 1,420 mL × 1.5 kcal/mL = 2,130 kcal/day, which provides approximately 31 kcal/kg for this 68 kg patient and exceeds the recommended 25–30 kcal/kg/day target 1
Protein content: Jevity 1.5 contains approximately 60 g protein per liter, delivering 85 g protein/day from 1,420 mL, which equals 1.25 g/kg and falls within the recommended 1.0–1.5 g/kg/day range for postoperative elderly patients 2, 1
Carbohydrate: Approximately 200–220 g/day from this volume, providing the majority of non‑protein calories 2
Fat: Approximately 70–80 g/day, with a balanced fatty acid profile 3
Fluid and Hydration Status
Free water content: Jevity 1.5 is approximately 85% water, so 1,420 mL delivers roughly 1,207 mL of free water 1
Additional fluid requirement: The patient receives 300 mL daily from ice chips, bringing total fluid intake to approximately 1,507 mL 1
Fluid adequacy: For a 68 kg patient, the recommended fluid intake is 25–30 mL/kg/day (1,700–2,040 mL/day), meaning this regimen provides approximately 1,507 mL and falls 200–500 mL short of optimal hydration 1
Recommendation for fluid supplementation: Add 300–500 mL of free‑water flushes through the gastrostomy tube daily to meet total fluid goals of 1,800–2,100 mL 1
Micronutrient Coverage
Complete vitamin provision: Jevity 1.5 at 2,130 kcal/day provides 100% or more of the Daily Value for all essential vitamins, including water‑soluble (B‑complex, C) and fat‑soluble (A, D, E, K) vitamins 2, 1
Mineral content: This volume delivers adequate amounts of calcium, phosphorus, magnesium, zinc, and selenium to meet daily requirements 2
Fiber content: Jevity contains 14.4 g/L of soy polysaccharide fiber, so 1,420 mL provides approximately 20 g of fiber/day, which helps regulate bowel function in tube‑fed patients 4, 5
Special considerations for postoperative patients: Monitor vitamin B12 (especially if terminal ileum resected), iron, calcium, and vitamin D levels, as absorption may be compromised after gastrointestinal surgery 2
Administration Protocol for This Patient
Bolus feeding schedule: At 2 months postoperative, divide the 1,420 mL into 4–5 bolus feedings of approximately 280–355 mL each, administered over 15–60 minutes 1
Example schedule: 300 mL at 08:00,12:00,16:00,20:00, and 220 mL at bedtime (5 feedings totaling 1,420 mL) 1
Full‑strength administration: Do not dilute Jevity 1.5; full‑strength formula is safe at 2 months postoperative and dilution increases infection risk without clinical benefit 1
Head elevation: Maintain head of bed at ≥30° during feeding and for 30 minutes after to minimize aspiration risk 1
Monitoring Requirements
Gastric residual volumes: Check every 4 hours initially; hold feeding if residuals exceed 200 mL and reassess tolerance 1
Electrolyte monitoring: Check comprehensive metabolic panel closely during the first few days after any change in feeding regimen to detect sodium, potassium, magnesium, calcium, and phosphorus disturbances 6
Weight and nutritional parameters: Assess weight weekly and monitor serum albumin to track nutritional status 1
Urine output: Target urine volume ≥800–1,000 mL/day with urine sodium >20 mmol/L to confirm adequate hydration 6
Common Pitfalls to Avoid
Hypotonic fluid intake: Do not encourage hypotonic oral fluids (tea, coffee, juices) in jejunostomy patients, as they paradoxically increase stomal sodium losses and worsen dehydration; use glucose‑saline oral rehydration solution with sodium ≥90–100 mmol/L instead 6
Diarrhea management: If diarrhea occurs, first evaluate medication side‑effects (especially antibiotics and Clostridium difficile toxin) rather than immediately attributing it to the formula 1, 5
Refeeding syndrome: Although risk is lower at 2 months postoperative, patients with prior malnutrition should still be monitored for electrolyte disturbances, particularly phosphorus, during the first week of any feeding change 1
Inadequate free water: The most common error is failing to provide sufficient free‑water flushes beyond the formula volume, leading to dehydration and hypernatremia 1, 6