Pectin-containing liquid enteral nutrition for critical care: a historical control and propensity score matched study.

Authors:
Kensuke Nakamura
Kensuke Nakamura
Hokkaido University
Japan
Ryota Inokuchi
Ryota Inokuchi
The University of Tokyo Hospital
Japan
Kazutaka Fukushima
Kazutaka Fukushima
Chiba University
Japan
Hiromu Naraba
Hiromu Naraba
Hitachi General Hospital
Yuji Takahashi
Yuji Takahashi
Graduate School of Medicine
Japan
Tomohiro Sonoo
Tomohiro Sonoo
The University of Tokyo Hospital
Japan
Hideki Hashimoto
Hideki Hashimoto
School of Public Health
New Haven | United States
Kent Doi
Kent Doi
Graduate School of Medicine

Asia Pac J Clin Nutr 2019 ;28(1):57-63

Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Tokyo, Japan.

Background And Objectives: Pectin-containing liquid enteral nutrition (PCLEN) contains pectin, which becomes solid in the stomach and therefore mitigates vomiting and diarrhea. Its efficacy for use in critical care medicine was evaluated.

Methods And Study Design: We used liquid enteral nutrition (LEN) (traditional LEN (TLEN)) as the primary LEN at the emergency and critical care center. We adopted PCLEN as the primary LEN from 2014. During 2012-2016, 954 patients admitted to intensive care units and emergency wards were given PCLEN or TLEN. We conducted propensity score matching for 693 eligible patients for age, sex, and organ dysfunctions for six organs.

Results: We included 199 PCLEN patients and 199 TLEN patients. Severity was higher in the PCLEN group. The enteral nutrition failure rate was significantly lower for PCLEN than for TLEN. The diarrhea incidence rates were 28.1% vs 38.2% (p=0.033), and the incidence rates of nosocomial pneumonia were 4.5% and 9.6% (p=0.048). For PCLEN, the enteral nutrition failure rates were not different for patients with gastric acid inhibitors and without them.

Conclusions: PCLEN can be used effectively for critically ill patients irrespective of the use of gastric acid inhibitors. It can decrease the incidence of enteral nutrition failure and diarrhea.

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Source
http://dx.doi.org/10.6133/apjcn.201903_28(1).0009DOI Listing
January 2019
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