Because of its components, tolerance is extremely high. Flushing is only required before and after administration to keep the tube patent. Multiple packets can be used with high tolerance at one time. Proposed recommendations to increase protein delivery and preserve lean body mass in the ICU were discussed at Clinical Nutrition Week 2017 with a recommendation of 30gm of high quality supplement 4-6 times a day as necessary according to protein prescription.
ProSource TF is not to be used as a sole source of nutrition as it does not meet a patients essential fatty acid needs. Hydration needs should be customized according to specific patient needs, but TF does not require any additional flushing for function or safety.
Paddon-Jones, D., & Rasmussen, B. B. (2009). Dietary protein recommendations and the prevention of sarcopenia. Current Opinion in Clinical Nutrition and Metabolic Care, 12(1), 86-90. doi:10.1097/mco.0b013e32831cef8b
Weijs, Peter Jm, et al. “Early high protein intake is associated with low mortality and energy overfeeding with high mortality in non-Septic mechanically ventilated critically ill patients.” Critical Care, vol. 18, no. 6, 2014, doi:10.1186/s13054-014-0701-z.
Fccm, Y. A. (2013). Permissive underfeeding versus target enteral feeding in adult critically ill patients. Http://isrctn.org/>. doi:10.1186/isrctn68144998