Health Outcomes and Quality of Life Indices of Children Receiving Blenderized Feeds via Enteral Tube.

OBJECTIVE: To determine whether clinical and patient-reported outcomes differ in children receiving blenderized diets compared with conventional formula. STUDY DESIGN: We conducted a prospective cohort study of 70 children aged 1-18 years receiving blenderized diets vs conventional formula via feeding tube. We assessed rates of hospitalization and visits to the emergency department (ED) at Boston Children's Hospital in 2017 and Likert scale addressing satisfaction with feeding regimen; Pediatric Gastroesophageal Reflux Disease Symptom and Quality of Life Questionnaire; Pediatric Quality of Life Inventory; and Pediatric Quality of Life Inventory Gastrointestinal Symptoms Scale. RESULTS: Participants receiving blenderized diets (n = 42, 60%) did not differ in demographics or comorbid diagnoses from those receiving conventional formula (n = 28, 40%). Rates of total visits to the ED (0.8 ± 1.5 vs 1.4 ± 2.7, P = .05), total admissions (0.8 ± 1.2 vs 1.7 ± 2.3, P = .01), and respiratory-related admissions (0.2 ± 0.5 vs 0.6 ± 0.8, P = .04) per year were significantly lower in participants receiving blenderized diets, and respiratory-related visits to the ED trended toward significance (0.1 ± 0.4 vs 0.4 ± 0.8, P = .08). Compared with those receiving conventional formula, participants on blenderized diets reported greater satisfaction ratings (Likert scale 4.3 ± 1.0 vs 3.3 ± 1.2, P = .001), lower symptom (0.7 ± 0.8 vs 1.2 ± 1.1, P = .03), and total (0.8 ± 0.8 vs 1.2 ± 1.0, P = .02) scores on Pediatric Gastroesophageal Reflux Disease Symptom and Quality of Life Questionnaire and greater scores on the Pediatric Quality of Life Inventory Gastrointestinal Symptoms Scale, indicating less nausea and vomiting (64.0 ± 22.6 vs 49.0 ± 37.9, P = .02), abdominal pain (65.0 ± 26.8 vs 56.4 ± 33.9, P = .04), diarrhea (87.9 ± 15.5 vs 73.6 ± 26.3, P = .004), and fewer total symptoms (70.2 ± 16.3 vs 62.3 ± 19.6, P = .03). CONCLUSIONS: Blenderized diets are associated with decreased healthcare use, improved symptom scores, and increased patient satisfaction compared with conventional formulas.

Determining Viscosity of Blenderized Formula: A Novel Approach Using the International Dysphagia Diet Standardisation Initiative Framework.

BACKGROUND: Blenderized formula (BF) can be used in place of standard enteral formula and is composed of blenderized whole foods and purees. Benefits of using BF include reduced vomiting and retching, in part related to a higher viscosity. Commercially prepared BFs vary significantly in viscosity when comparing available products. Viscosity can be measured using a viscometer, although this requires expensive and sophisticated equipment. We proposed an alternative method to describe viscosity of BFs using the International Dysphagia Diet Standardisation Initiative (IDDSI) framework. This flow test provides a simple and objective method to describe liquid thickness and requires only a 10-mL luer tip syringe and stopwatch. METHODS: Full-strength BFs were measured using the IDDSI flow test and compared with a standard enteral formula. BFs were then diluted until a slightly thick viscosity was achieved, which correlated to the viscosity of the reference formula. RESULTS: IDDSI flow-test results indicated that undiluted BFs ranged in viscosity, from slightly thick to extremely thick, when measured at room temperature. The volume of water required to achieve a slightly thick viscosity ranged from 0 to 270 mL per serving, resulting in a wide variation in dilution of formula. CONCLUSION: The IDDSI flow test was simple to perform and can serve as a tool to determine the viscosity of BFs.