Main Organiser

Julius Centre University of Malaya

Co-organiser

Department of Social and Preventive Medicine, Faculty of Medicine, University of Malay

Supported by

University of Malaya

A MULTI-CENTRE, RANDOMISED, DOUBLE-BLIND, CONTROLLED TRIAL DETERMINING THE EFFECT OF ADDITIONAL FRUCTO- OLIGOSACCHARIDES ON FAECAL MICROBIOTA AND SHORT-CHAIN FATTY ACIDS AMONG CRITICAL CARE PATIENTS RECEIVING ENTERAL NUTRITION

Author

H A Majid 1,2 , J Cole 2 , CL. Reid 3 , T. Sherry 3 , R.J. Beale 3 M. Ervine 4 , P.W. Emery 2 and K. Whelan 2

Institution

1 University of Malaya, Department of Social and Preventive Medicine, Malaysia
2 King’s College London, Diabetes and Nutritional Sciences Division, London, UK
3 Intensive Care Unit, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
4 Intensive Care Unit, King’s College Hospital NHS Foundation Trust, London, UK.

Abstract

Objectives: Patients who develop diarrhoea during enteral nutrition (EN) have been shown to have lower faecal bifidobacteria. The aim of this study was to investigate the effect of additional fructo- oligosaccharides (FOS) intake on the gastrointestinal (GI) microbiota, short-chain fatty acids (SCFA) and faecal output in patients receiving EN on the ICU

Methods: Adult patients in ICU who were starting EN with a formula containing fiber and FOS were eligible for inclusion. Patients with a GI disorder or prescribed lactulose were excluded. Patients were randomised to receive 7 g/d of additional FOS or placebo (maltodextrin) for up to 14-d. A fresh faecal sample was collected from each patient at baseline and following 7 to 14 days of EN and supplementation with additional FOS/placebo. The faecal were analysed using fluorescent in situ hybridization and gas liquid chromatography. Faecal output was monitored daily using the King’s stool chart.

Results: Of the 35 patients who were randomised and started the study, 22 (9 female, 13 male) completed 7-14 days of the intervention. There were no differences in baseline characteristics between the groups. Following 7-14 days, there were significantly lower concentrations of bifidobacteria in patients who were given additional FOS. However, there were no differences in the SCFA concentrations, daily faecal score and incidence of diarrhoea between the two groups.

Conclusion: Delivery of an additional 7g/d of FOS shown significant lowering of faecal bifidobacteria in ICU patients receiving EN within 7-14 days, but does not impact upon SCFA concentrations and faecal output.