Clinical Trials Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2020; 8(19): 4410-4415
Published online Oct 6, 2020. doi: 10.12998/wjcc.v8.i19.4410
Optimal hang time of enteral formula at standard room temperature and high temperature
Narisorn Lakananurak, Nutbordee Nalinthassanai, Wanlapa Suansawang, Palakorn Panarat
Narisorn Lakananurak, Nutbordee Nalinthassanai, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
Wanlapa Suansawang, Department of Dietetic and Diet Therapy, King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
Palakorn Panarat, Department of Medicine, Queen Savang Vadhana Memorial Hospital, Chon Buri 20110, Thailand
Author contributions: Lakananurak N, Nalinthassanai N, Suansawang W, and Panarat P contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Institutional review board statement: The study was approved by the Institutional Review Board (IRB) of the Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand (IRB number 645/59).
Conflict-of-interest statement: No potential conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Narisorn Lakananurak, MD, MSc, Doctor, Department of Medicine, Faculty of Medicine, Chulalongkorn University, 254 Phayathai Road, Pathumwan, Bangkok 10330, Thailand. narisorn.l@chula.ac.th
Received: July 20, 2020
Peer-review started: July 20, 2020
First decision: August 22, 2020
Revised: September 5, 2020
Accepted: September 12, 2020
Article in press: September 12, 2020
Published online: October 6, 2020
Processing time: 69 Days and 19.4 Hours
ARTICLE HIGHLIGHTS
Research background

Optimal hang time is one of important factors to prevent bacterial contamination during enteral nutrition administration. However, the recommendation for optimal hang time was extrapolated from reports of enteral nutrition contamination in patients with diarrhea and prolonged hang time. No previous studies have directly investigated optimal hang time of blenderized and reconstituted powered formulas at standard room temperature and high temperature.

Research motivation

Despite high risk of contamination, studies that directly evaluated the optimal hang time of blenderized and reconstituted powered formulas at standard room temperature and high temperature are scarce. The investigation of optimal hang time will help prevent bacterial contamination in both hospital and home-based enteral nutrition support.

Research objectives

This study investigated the optimal hang time of both types of formulas at standard room temperature and high temperature.

Research methods

Ten specimens of blenderized formula and 10 specimens of reconstituted powdered formula were prepared using aseptic techniques. Five specimens of each formula were administered at 25 °C and 32 °C. Simulated administration was done in an incubator. The samples were collected at 0, 2, 4, 6 h and aerobic culture was performed. Food and drug administration criteria were used to determine the unacceptable levels of bacterial contamination.

Research results

Unacceptable contamination for blenderized formula began at 4 h at 25 °C and at 2 h at 32 °C. As for the reconstituted powdered formula, there was no bacterial growth in all specimens up to 6 h at both temperatures.

Research conclusions

The optimal hang time of the blenderized formula should be limited to 2 h at standard room temperature and be administered by bolus method at high temperature, while a reconstituted powdered formula may hang up to 6 h at both temperatures.

Research perspectives

The findings from the current study helps establish and provide the groundwork for further large-scale studies to evaluate optimal hang time for blenderized and reconstituted powered formulas.