Tolerability and efficacy of a low-volume enteral supplement containing key nutrients in the critically ill.

Abstract

BACKGROUND & AIMS:

To compare early supplementation with antioxidants and glutamine using a low-volume enteral supplement containing key nutrients to an energy adjusted standard elementary diet and to investigate its effect on clinical efficacy and tolerability in critically ill patients with sepsis/SIRS. The primary endpoints were length of stay in the ICU and sufficient enteral feed.

METHODS:

This was a randomized, prospective, single-blind, controlled study in 58 critically ill patients (56.9% male, mean age 46.7 years, mean APACHE II score 21.6). They received either a low-volume enteral supplement containing key nutrients or a diluted standard nutrition solution. After 10 or 14 days inflammatory parameters, catecholamine need, and maximal enteral delivery were determined.

RESULTS:

Patients receiving a low-volume enteral supplement containing key nutrients did not reach sufficient enteral feed more often than controls (76 vs. 62%, respectively, p = 0.17). The difference in vitamin E and selenium uptake was higher in the treatment group than controls (12.4 vs. 3.7 and 54.7 vs. 16.3, respectively, p ≤ 0.011). Parameters such as fever, antibiotic treatment, artificial ventilation, and death were comparable. This was also true for days of ICU or hospital stay (33 ± 23 and 49 ± 34 days, respectively).

CONCLUSIONS:

The low-volume enteral supplement containing key nutrients was well tolerated and led to a better vitamin E and selenium supply. However, it did not affect length of ICU or hospital stay. Further studies are necessary to determine which disease-specific subgroups may benefit from this supplementation or which group may be harmed.

• Authors: Andrea Schneider, Andrea Markowski, Michael Momma, Claudia Seipt, Birgit Luettig, Johannes Hadem, Michaela Wilhelmi, Michael P Manns, Jochen Wedemeyer
• Journal: Clinical nutrition (Edinburgh, Scotland) (Clin Nutr) Vol. 30 Issue 5 Pg. 599-603 (Oct 2011) ISSN: 1532-1983 [Electronic] England
• PMID: 21621886 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Chemical References

• Antioxidants
• Glutamine
• Vitamin E
• Selenium

Topics

• Adult
• Antioxidants (administration & dosage, adverse effects, therapeutic use)
• Critical Illness
• Energy Intake
• Enteral Nutrition (adverse effects)
• Female
• Fever (complications, etiology, prevention & control)
• Food, Formulated (adverse effects, analysis)
• Glutamine (administration & dosage, adverse effects, therapeutic use)
• Humans
• Intensive Care Units
• Length of Stay
• Male
• Middle Aged
• Pilot Projects
• Selenium (administration & dosage)
• Sepsis (complications, physiopathology, therapy)
• Single-Blind Method
• Systemic Inflammatory Response Syndrome (complications, physiopathology, therapy)
• Vitamin E (administration & dosage)