Errors in emergency feeds in inherited metabolic disorders: a randomised controlled trial of three preparation methods. Issue 10 (3rd June 2010)

• Record Type: Journal Article
• Authors: Gokmen-Ozel, H; Daly, A; Davies, P; Chahal, S; MacDonald, A
• Is Part Of: Archives of disease in childhood. Volume 95:Issue 10(2010)
• Page Start: 776
• Page End: 780
• Publication Date: 2010-06-03
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/adc.2010.161711
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Objective: Glucose polymer-based emergency feeds (EF), used during illness to prevent metabolic decompensation and encephalopathy in inherited metabolic disorders, should be produced accurately and safely. Design: In a randomised, prospective, controlled study, the aim was to investigate if when preparing age-appropriate EF, a pre-measured sachet of glucose polymer, compared with scoops and weighing (using digital scales), decreased carer errors. Subjects: 47 carers (3 men, 44 women) of 52 inherited metabolic disorders patients were recruited. Setting and intervention: The carers made EF using all three techniques (weighing, scoops and pre-measured sachets) under supervision in controlled and home conditions. A 100-ml aliquot of each EF was analysed for carbohydrate concentration. Results: Under controlled preparation conditions, with 1 litre EFs, the % median glucose polymer concentration closest to target amounts was (1) pre-measured sachets (105%), (2) weighing (107%) and (3) scoops (118%; p<0.001). Similarly, under home conditions, the closest method was (1) pre-measured sachets (111%), (2) weighing (112%) and (3) scoops (118%; p<0.05). Under home preparation conditions, with 200 ml EFs, the pre-measured sachets were more likely to be within 20% of target weight than weighing (p<0.05), but there was no difference with scoops. Common errors observed were inaccurate water measurements (40% controlled and home conditions), incorrect scoop measurements and difficulty using digital scales. Conclusions: Overall, using pre-measured sachets was more accurate in EF production. Pre-measured sachets are likely to decrease preparation error and, therefore, reduce the risk of feed intolerance, particularly osmotic diarrhoea and consequential metabolic decompensation and encephalopathy.