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

Kensuke Nakamura ； Ryota Inokuchi ； Kazutaka Fukushima ； Hiromu Naraba ； Yuji Takahashi ； Tomohiro Sonoo ； Hideki Hashimoto ； Kent Doi ； Naoto Morimura

《Asia Pacific Journal of Clinical Nutrition》 28卷1期 (2019/03) Pp. 57-63

https://doi.org/10.6133/apjcn.201903_28(1).0009

摘要

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.

關鍵字

enteral nutrition ； critical care ； pectin ； diarrhea ； intensive care