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

Qiu, Chunfang; Chen, Chuanxi; Zhang, Weixing; Kou, Qiuye; Wu, Sheng-Nan; Zhou, Lei; Liu, Jiyun; Ma, Gang; Chen, Juan; Chen, Minying; Luo, Hua; Zhang, Xiaofei; Lai, Jianbo; Yu, Zhihui; Yu, Xuefeng; Liao, Wei; Guan, Xiangdong; Ouyang, Bo

doi:10.1177/0148607115601858

Cited by 29 publications

(28 citation statements)

References 31 publications

(60 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Davies et al also included all studies that delivered 2 different amounts of protein, irrespective of whether this was within the current guideline recommendations. Of the 8 studies included by Davies et al that delivered predominately EN, [44][45][46][47][48][49][50][51] none of these achieved ࣙ1.2 g/kg per day protein in the intervention group (ie, international guideline recommendations) and <1.2 g/kg per day in the comparator group. Furthermore, there have been trials recently published in this field, with 4 out of the 6 studies included in the current systematic review published after the review by Davies et al 20 The 2 systematic reviews conducted prior to Davies et al 22,42 also incorporated both EN and PN and multiple study methodologies.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review With Meta‐Analysis of Patient‐Centered Outcomes, Comparing International Guideline–Recommended Enteral Protein Delivery With Usual Care

Fetterplace

Gill

Chapple

et al. 2019

J Parenter Enteral Nutr

View full text Add to dashboard Cite

Background: International guidelines recommend that protein be administered enterally to critically ill patients at doses between 1.2 and 2 g/kg per day Observational data indicate that patients frequently receive less protein. The aim of this systematic review was to evaluate patient-centered outcomes with guideline-recommended enteral protein compared with usual care. Methods: A systematic review was performed of randomized controlled trials including critically ill adult patients provided predominately enteral nutrition with mean protein at ࣙ1.2 g/kg per day (intervention) and <1.2 g/kg per day (comparator). Random-effects models were applied for outcomes reported in ࣙ3 trials. Results: Of 1375 abstracts, 69 full-text articles were reviewed, and 6 trials meet the inclusion criteria, including 511 patients. The intervention group received a mean (SD) of 1.3 (0.08) g/kg per day, and the comparator group received 0.75 (0.15) g/kg per day protein. Insufficient data were available for meta-analyses on the primary outcome (muscle mass or strength). According to our meta-analyses, mortality at 28 days (5 studies) (risk ratio 0.92 [95% Cl 0.63-1.35], P = .66) and the durations of intensive care unit (6 studies) and hospital admission (4 studies) were similar between the intervention and comparator, with some uncertainty due to sample sizes and heterogeneity. Conclusion: There are insufficient data to conclude whether protein provision within the current international guideline recommendations improves outcomes. In a limited dataset, enteral protein intakes near the lower level of current recommendations do not appear to reduce admission duration or mortality when compared with usual care in critically ill.

show abstract

Section: Discussionmentioning

confidence: 99%

Systematic Review With Meta‐Analysis of Patient‐Centered Outcomes, Comparing International Guideline–Recommended Enteral Protein Delivery With Usual Care

Fetterplace

Gill

Chapple

et al. 2019

J Parenter Enteral Nutr

View full text Add to dashboard Cite

show abstract

“…Using this nomograph model, we can apply prokinetics early and enact a conservative feeding protocol or use a modified enteral formula to reduce the occurrence of intolerance. A growing body of evidence shows that the use of prokinetics [ 19 ] (such as erythromycin and metoclopramide; moderate-quality evidence), modified enteral formula [ 2 , 20 – 24 ], feeding protocol (PEP uP protocol) [ 25 ], nursing-related factors [ 26 ], blood glucose control [ 27 ], abdominal massage [ 28 , 29 ] and acupuncture [ 30 ] can effectively decrease the incidence of FI. The overall purpose of this study was to establish and verify a risk prediction model for identifying patients with a high-risk of TFI after gastric cancer surgery.…”

Section: Discussionmentioning

confidence: 99%

Construction of a model predicting the risk of tube feeding intolerance after gastrectomy for gastric cancer based on 225 cases from a single Chinese center

Xiao-yong

et al. 2017

Oncotarget

View full text Add to dashboard Cite

Identifying patients at high risk of tube feeding intolerance (TFI) after gastric cancer surgery may prevent the occurrence of TFI; however, a predictive model is lacking. We therefore analyzed the incidence of TFI and its associated risk factors after gastric cancer surgery in 225 gastric cancer patients divided into without-TFI (n = 114) and with-TFI (n = 111) groups. A total of 49.3% of patients experienced TFI after gastric cancer. Multivariate analysis identified a history of functional constipation (FC), a preoperative American Society of Anesthesiologists (ASA) score of III, a high pain score at 6-hour postoperation, and a high white blood cell (WBC) count on the first day after surgery as independent risk factors for TFI. The area under the curve (AUC) was 0.756, with an optimal cut-off value of 0.5410. In order to identify patients at high risk of TFI after gastric cancer surgery, we constructed a predictive nomogram model based on the selected independent risk factors to indicate the probability of developing TFI. Use of our predictive nomogram model in screening, if a probability > 0.5410, indicated a high-risk patients would with a 70.1% likelihood of developing TFI. These high-risk individuals should take measures to prevent TFI before feeding with enteral nutrition.

show abstract

“…22 Data indicate that MCT intake is associated with decreases in GI symptoms. 23 A high MCT:LCT ratio helps enhance fat absorption and metabolism, thereby promoting tolerance. 22,24,25 Protein source and form also influence tolerance.…”

Section: Nutrition and Metabolic Insightsmentioning

confidence: 99%

Meeting Calorie and Protein Needs in the Critical Care Unit: A Prospective Observational Pilot Study

Yamamoto¹,

Allen

Jones

et al. 2020

Nutr Metab Insights

View full text Add to dashboard Cite

Background: Inadequate calorie and protein intake during critical illness is associated with poor clinical outcomes. Unfortunately, most critically ill patients do not consume adequate levels of these nutrients. An enteral formula with appropriate macronutrient composition may assist patients in meeting nutritional goals. Design: This study was a single center, prospective, observational study of 29 adults in the medical intensive care unit who required enteral nutrition for at least 3 days. Subjects received a calorically dense, enzymatically hydrolyzed 100% whey peptide-based enteral formula for up to 5 days to assess the ability to achieve 50% of caloric goals within the first 3 days (primary outcome), the daily percentage of protein goals attained and gastrointestinal tolerance (secondary outcomes). Result: A total of 29 subjects consented and began the study. Four subjects dropped out before first day and 25 subjects were included in analyses. Subjects were aged 55.5 ± 16.9 years with mean body mass index (BMI) of 27.9 ± 7.5 kg/m2. Most (92%) subjects were on a mechanical ventilator and experienced organ failure. At least 50% of caloric and protein goals were achieved in 78.9% and 73.7% of the subjects, respectively, during the first 3 days. Overall, 75.0 ± 26.3% and 69.3 ± 26.7% of calorie and protein goals were achieved using the study formula. Conclusions: Subjects fed enterally with a calorically dense, enzymatically hydrolyzed 100% whey peptide-based enteral formula exceeded 50% of caloric and protein goals in most critically ill subjects included in this study. Use of study formula did not lead to severe gastrointestinal intolerance.

show abstract

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

Abstract: The fat-modified enteral formula containing MCT, carnitine, and taurine may improve feeding tolerance in critically ill patients.

Cited by 29 publications

References 31 publications

Systematic Review With Meta‐Analysis of Patient‐Centered Outcomes, Comparing International Guideline–Recommended Enteral Protein Delivery With Usual Care

Systematic Review With Meta‐Analysis of Patient‐Centered Outcomes, Comparing International Guideline–Recommended Enteral Protein Delivery With Usual Care

Construction of a model predicting the risk of tube feeding intolerance after gastrectomy for gastric cancer based on 225 cases from a single Chinese center

Meeting Calorie and Protein Needs in the Critical Care Unit: A Prospective Observational Pilot Study

Contact Info

Product

Resources

About