Enteral feeding (EF) is generally well-tolerated, even in critically ill patients. Although EF has been associated with fewer infectious complications, lower costs, and a reduced length of hospital stay, there are common complications related to the infusion of EF formulas, such as aspiration pneumonia and upper gastrointestinal intolerance symptoms. Furthermore, it is beneficial to carefully increase protein delivery while allowing for the accumulation of a moderate caloric deficit, aiming for a calorie-to-protein ratio of less than 50:1 during the first week of critical illness. This project aims to develop fluid EF formulas with a high protein-to-energy ratio for critically ill patients who have difficulty swallowing. Complex biphasic structures (bigels) will be utilized for this purpose. Bigels are unique semi-solid structures created by combining two immiscible gels (oleogel-in-hydrogel or hydrogel-in-oleogel) at a high shear rate, which then exist as a uniform dispersion throughout. During this project, new knowledge will be gained to help understand how the release profile of nutrients (especially proteins) from semi-solidified biphasic structures after ingestion can be affected by changes in the network formation and rheological properties (viscosity, fluidity) of these structures. In this context, different strategies will be explored to modulate protein hydrogel functionality throughout digestion by analyzing gel interaction with digestive fluids (swelling/shrinking, molecular interaction) and the properties of the biopolymeric building blocks, which are affected by changes in pH, ionic strength, and the presence of enzymes in the gastrointestinal tract. The nutritional quality indices of the obtained fluid EF formulations will also be monitored. The approaches and solutions developed in this project will undoubtedly be applicable in the clinical and nutritional care of critically ill patients.
Project funding:
Research Council of Lithuania, Projects carried out by researchers’ teams
Project results:
• Knowledge about food-grade proteins and their mixtures as possible gelators to meet the following requirements: 1) complies with the WHO recommended amino acid profile; 2) does not coagulate in the gastric environment and shows fast degradation in the gastrointestinal tract; 3) has good gelation properties for the development of a stable bigel structure;
• Knowledge about changes in protein hydrogels within the gastrointestinal tract that are extremely influenced by their swelling, disintegration, collapse, erosion, and molecular interactions;
• Knowledge about changes in oleogels within the gastrointestinal tract that depend on both the mechanical strength of the bulk structure and the hydrolysis of oleogelators, affecting their transient clusters;
• Designed semi-solid bigel structure as enteral feeding formulation with a calorie-to-protein ratio of <50:1 and the viscosity corresponding to the third-level dysphagia fluids.
Period of project implementation: 2025-11-03 - 2028-10-31
Project coordinator: Kaunas University of Technology
