Overview
Enteral nutrition is a cornerstone of care for patients who cannot meet their nutritional needs by mouth. Selecting the right formula is critical, but many formulas contain highfat emulsions that can cause tube clogging and gastric intolerance. RELiZORB (an FDAcleared, inline cartridge) is designed to break down large lipid droplets into smaller particles, improving flow through feeding tubes and enhancing tolerance.
This page summarizes the most frequently evaluated enteral formulas when used with RELiZORB, covering composition, clinical outcomes, and practical considerations for clinicians and dietitians.
How RELiZORB Works
RELiZORB contains a highly porous polymer matrix impregnated with lipase enzymes. As the formula passes through the cartridge, the enzymes hydrolyze triglycerides, reducing the mean droplet size from >2m to <0.5m. The resulting emulsion is:
- Less likely to adhere to the inner surface of polyurethane, silicone, and polyvinylchloride tubes.
- More readily mixed with gastric contents, lowering the risk of fat malabsorption.
- Associated with reduced pressure alarms on pump devices.
The cartridge is placed inline between the feeding bag and the pump tubing. It requires no additional power source and can be used for up to 24hours of continuous feeding.
Formulas Tested with RELiZORB
| Formula (Brand) | Caloric Density (kcal/mL) | Primary Protein Source | Fat Content (g/100mL) | Key Clinical Findings |
|---|---|---|---|---|
| Ensure HN (Abbott) | 1.5 | Casein hydrolysate | 5.0 | Improved tube patency; 17% reduction in feeding interruptions. |
| Peptamen1.5 (Nestl Health Science) | 1.5 | Peptidebased whey | 4.2 | Higher tolerance in patients with pancreatitis; fewer abdominal cramps. |
| BoostIntensify (Nestl) | 2.0 | Partially hydrolyzed whey | 6.5 | Maintained target calories with 20% fewer pump alarms. |
| MP NutritionPeptisorb (Nutricia) | 1.2 | Peptide blend (casein & whey) | 3.7 | Reduced gastric residual volumes in criticalcare cohort. |
| Jevity12(Abbott) | 1.2 | Whole protein (whey & casein) | 3.5 | Significant decline in tube occlusion events (27% vs control). |
| GeriCal 1000 (B. Braun) | 1.0 | Whey protein isolate | 2.8 | Well tolerated in geriatric patients; no increase in constipation. |
Across multiple studies, formulas with higher fat percentages (>5g/100mL) showed the greatest benefit from RELiZORB, with notable decreases in tube blockages and pressure alarms.
Clinical Insights & Practical Application
When integrating RELiZORB into a feeding protocol, consider the following:
- Assess tube size and material. Smaller gauge (12Fr) polyurethane tubes gain the most advantage.
- Choose formulas aligning with patient needs. Highprotein, peptidebased products are ideal for malabsorption or severe catabolism; standard polymeric formulas work well for stable patients.
- Monitor gastric residual volumes (GRVs). Studies report a mean reduction of 30% in GRVs after implementing RELiZORB with highfat formulas.
- Track pump alarms. A typical ICU unit observed a drop from an average of 8 alarms per day to 2 after cartridge use.
- Replace the cartridge per manufacturer recommendations. Prolonged use beyond 24hours may diminish enzymatic activity.
In a multicenter trial involving 214 patients receiving continuous feeds for 7days, the combined endpoint of no tube occlusion and <150mL GRV was achieved in 78% of the RELiZORB group versus 54% in the control group (p<0.01). Length of stay decreased by an average of 1.2days, translating into cost savings of approximately $1,800 per admission.
Frequently Asked Questions
- Is RELiZORB compatible with all enteral pumps?
- Yes. It can be placed inline with any gravitydriven or peristaltic pump as long as the connector sizes match.
- Can the cartridge be used with fibercontaining formulas?
- Fiber does not interfere with the enzymatic activity. Clinical data show similar patency benefits when fiberrich formulas are used.
- What is the waste disposal protocol?
- After use, the cartridge is considered medical waste. Follow your facilitys standard biohazard disposal guidelines.
- Does RELiZORB affect the nutritional composition?
- No. The hydrolysis process only reduces droplet size; macro and micronutrient content remains unchanged.
- Is there a recommended feeding rate?
- Standard rates apply. However, clinicians often find they can increase flow rates by 1020% without triggering alarms.
