Fat-Modified Enteral Formula Improves Feeding Tolerance in Critically Ill Patients: A Multicenter, Single-Blind, Randomized Controlled Trial.

Autor: Qiu C; 1 Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China., Chen C; 1 Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China., Zhang W; 2 Department of Intensive Care Unit, Peking University Shenzhen Hospital, Shenzhen, P.R. China., Kou Q; 3 Department of Intensive Care Unit, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China., Wu S; 4 Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen, P.R. China., Zhou L; 5 Department of Intensive Care Unit, The First People's Hospital of Foshan, Foshan, P.R. China., Liu J; 6 Department of Intensive Care Unit, The First People's Hospital of Guangzhou, Guangzhou, P.R. China., Ma G; 7 Department of Intensive Care Unit, University Cancer Center, Guangzhou, P.R. China., Chen J; 1 Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China., Chen M; 1 Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China., Luo H; 2 Department of Intensive Care Unit, Peking University Shenzhen Hospital, Shenzhen, P.R. China., Zhang X; 3 Department of Intensive Care Unit, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China., Lai J; 4 Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen, P.R. China., Yu Z; 5 Department of Intensive Care Unit, The First People's Hospital of Foshan, Foshan, P.R. China., Yu X; 6 Department of Intensive Care Unit, The First People's Hospital of Guangzhou, Guangzhou, P.R. China., Liao W; 7 Department of Intensive Care Unit, University Cancer Center, Guangzhou, P.R. China., Guan X; 1 Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China., Ouyang B; 1 Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China.
Jazyk: angličtina
Zdroj: JPEN. Journal of parenteral and enteral nutrition [JPEN J Parenter Enteral Nutr] 2017 Jul; Vol. 41 (5), pp. 785-795. Date of Electronic Publication: 2015 Sep 08.
DOI: 10.1177/0148607115601858
Abstrakt: Background: Improvement of fat digestion and absorption was supposed to relieve feeding intolerance. This trial aimed to evaluate the effect of a fat-modified enteral formula on feeding tolerance in critically ill patients.
Materials and Methods: This trial was conducted in 7 hospitals in China. In total, 144 intensive care unit (ICU) patients with estimated need of enteral nutrition (EN) for at least 5 days were randomly given fat-modified enteral formula containing medium-chain triglycerides (MCT), carnitine, and taurine (interventional feed group, n = 71) or standard enteral formula (control feed group, n = 73). EN intake, feeding intolerance (diarrhea, vomiting, gastric retention, and abdominal distension) and outcomes (mechanical ventilator-free days of 28 days, length of ICU stay, length of hospital stay, and in-hospital mortality) were collected.
Results: Daily calories and protein intake were increased in the interventional feed group compared with the control feed group ( P < .01). Total incidence of feeding intolerance was 42.3% in the interventional feed group and 65.7% in the control feed group ( P < .001). Daily incidence of feeding intolerance was 11.3%, 18.3%, 14.1%, 25.4%, and 26.1% in the interventional feed group and 31.5%, 32.9%, 34.2%, 34.2%, and 30.4% in the control feed group from study days 1-5 ( P = .0083). Incidence of feeding intolerance without abdominal distention was 32.9% in the interventional feed group and 49.3% in the control feed group ( P = .047), while the incidence of abdominal distension was 26.8% in the interventional feed group and 43.8% in the control feed group ( P = .03). No significant differences existed in outcomes between the 2 groups.
Conclusions: The fat-modified enteral formula containing MCT, carnitine, and taurine may improve feeding tolerance in critically ill patients.
Databáze: MEDLINE
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