Is 1,062 mL of Jevity 1.5 Adequate for Daily Feeding?
No, 1,062 mL of Jevity 1.5 per day is insufficient for an 84-year-old, 68 kg man two months post-operative—this volume provides only 1,593 kcal and falls short of the recommended 1,700–2,040 kcal/day target (25–30 kcal/kg/day), and you should increase the daily volume to at least 1,200–1,400 mL to meet his caloric and protein requirements. 1
Caloric Deficit Analysis
Your current regimen delivers approximately 1,593 kcal/day (1,062 mL × 1.5 kcal/mL), which is below the minimum safe threshold of 1,500 kcal/day needed to ensure adequate micronutrient provision when using complete enteral formulas. 1
The target energy requirement for a 68 kg patient is 1,700–2,040 kcal/day (25–30 kcal/kg/day based on actual body weight), meaning the current volume creates a deficit of approximately 100–450 kcal daily. 1
At two months post-operative, this patient likely requires the higher end of the caloric range (closer to 30 kcal/kg/day or ~2,040 kcal) to support ongoing tissue repair and prevent further weight loss, which is common after gastrectomy. 2
Protein Inadequacy
The current volume provides only 64 grams of protein per day (Jevity 1.5 contains approximately 60 g protein per 1,000 mL), which equals 0.94 g/kg/day for this 68 kg patient. 1
Post-operative elderly patients require 1.2–1.6 g/kg/day of protein (82–109 grams daily for 68 kg), so the current regimen falls short by 18–45 grams of protein. 1
Inadequate protein intake in the post-operative period increases the risk of muscle wasting, delayed wound healing, and functional decline—outcomes that are particularly concerning in an 84-year-old patient. 1
Recommended Volume Adjustment
Increase the daily volume to 1,360–1,420 mL of Jevity 1.5 to deliver approximately 2,040–2,130 kcal and 82–85 grams of protein, which meets both caloric and protein targets. 1
Divide this volume into 4–5 bolus feedings of 270–355 mL each, administered over 15–60 minutes at regular intervals (e.g., 08:00,12:00,16:00,20:00, and optionally at bedtime). 1
At two months post-operative, bolus feeding via gastrostomy is strongly preferred over continuous infusion because it improves quality of life, permits greater mobility, and aligns with physiological gastric function. 3, 1
Fluid Management Considerations
Total daily fluid requirement for this patient is approximately 1,700–2,040 mL (25–30 mL/kg), and Jevity 1.5 provides about 85% water content. 1
If you deliver 1,360 mL of Jevity 1.5, this supplies approximately 1,156 mL of free water, leaving a deficit of 544–884 mL that must be met through additional free-water flushes. 1
Administer 300–500 mL of additional water per day via the gastrostomy tube, divided into flushes before and after each bolus feeding (e.g., 50–100 mL per flush × 4–5 feedings). 1
Monitoring Parameters
Check gastric residual volumes before each bolus feeding; if residuals exceed 200 mL, hold the feeding and reassess tolerance. 1
Monitor for signs of feeding intolerance, including abdominal distension, nausea, vomiting, and diarrhea—these symptoms may indicate the need to slow advancement or reduce bolus size. 1
Weigh the patient weekly and assess serum albumin, electrolytes (Na⁺, K⁺, Mg²⁺, Ca²⁺, PO₄³⁻), and nutritional parameters to ensure the feeding regimen is meeting his needs. 1
After gastrointestinal surgery, monitor serum levels of vitamin B₁₂, iron, calcium, and vitamin D because absorption of these nutrients may be compromised, particularly if the patient had gastric resection. 3, 1
Common Pitfalls to Avoid
Do not dilute Jevity 1.5—dilution increases infection risk, creates osmolality problems, and reduces nutrient delivery without any clinical benefit. 1
Avoid administering bolus feedings too rapidly (faster than 15 minutes for 270–355 mL), as this can cause bloating, dumping syndrome, and postprandial hypotension in elderly patients. 3, 4
Do not administer antihypertensive medications immediately before bolus feedings if the patient is prone to postprandial hypotension; instead, give these drugs at least 1–2 hours before or after feeding. 4
Never assume that the current volume is adequate simply because the patient tolerates it—tolerance does not equal nutritional sufficiency, and chronic underfeeding will lead to progressive weight loss and functional decline. 2, 5