Cost-benefit of semi-elemental formula versus standard polymeric formula in critically ill patients' management.

Introduction: Semi-elemental formulas are consistently utilized in providing nutritional support for critically ill patients, despite their higher costs in comparison to standard polymeric formulas. Method: A non-systematic search were conducted on the PubMed and Scopus databases to retrieve relevant English-language articles. Sixteen recent articles on the efficiency or comparative effects of semi-elemental diets published between 2000 and 2024 were identified. Conclusion: In most clinical scenarios, standard polymeric formulas are the preferred choice for initiating enteral nutrition in critically ill patients, as recommended by various associations and guidelines. However, in specific conditions such as short bowel syndrome and severe pancreatitis, semi-elemental formulas may be utilized at the onset of enteral feeding. For inflammatory bowel disease patients requiring enteral nutrition, semi-elemental formulas are recommended if they are unable to tolerate polymeric formulas. Nevertheless, studies have indicated that approximately 40% of critically ill patients in the intensive care unit experience enteral intolerance, with gastroparesis and diarrhea being the most prevalent symptoms. The occurrence of intolerance has been linked to an increase in the duration of hospitalization in the intensive care unit by approximately 3.6 days, as well as higher mortality rates and prolonged ventilator dependence. Cohort studies have demonstrated that a timely transition from standard polymeric formulas to semi-elemental formulas can effectively reduce patient care costs by 20%. Despite the fact that the cost of these formulas is 3.2 times higher than that of the standard formula, the potential 20% reduction in patient care costs provides a considerable economic rationale for their use in practice. Ultimately, there is no significant difference in total costs between patients receiving standard polymeric formulas and those receiving semi-elemental formulas. [ABSTRACT FROM AUTHOR]

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