Potassium sorbate reduces gastric colonization in patients receiving mechanical ventilation.
OBJECTIVE
Tube feeding might increase gastric burden of pathogenic bacteria and predispose patients to ventilator-associated pneumonia. We sought to determine whether a tube feeding formula acidified using potassium sorbate could reduce gastric burden of potentially pathogenic bacteria.


METHODS
Prospective, randomized, double-blind trial.


METHODS
RML Specialty Hospital, a facility with expertise in weaning patients from prolonged mechanical ventilation.


METHODS
Thirty patients recovering from prolonged mechanical ventilation.


METHODS
Patients were randomized to receive either a standard tube feeding formula (n=14) or a formula acidified using potassium sorbate to a pH of 4.25 (n=16).


RESULTS
Weekly quantitative cultures of gastric aspirates. The number of colony-forming units (CFUs) per patient was higher in the control than in the treatment group (53%+/-11% vs 9%+/-3.4%, threshold of >or=100,000 CFU/mL fluid, P=.003). The number of organisms isolated in each patient per week was higher among patients receiving standard tube feeding formula than among patients receiving acidified formula (0.91 +/- 0.20 vs 0.13 +/- 0.05 organisms per patient per week, threshold of >or=100,000 CFU/mL fluid, P=.0014). There was no difference in the incidence of gastrointestinal bleeding or ventilator-associated pneumonia between study groups.


CONCLUSIONS
Tube feeding formula acidified using potassium sorbate was well tolerated and reduced gastric bacterial burden in patients recovering from prolonged mechanical ventilation.
Tulaimat
Aiman
A
The Division of Pulmonary and Critical Care Medicine, Loyola University, Stritch School of Medicine, Chicago, IL 60611, USA.
Tulamait
Aiman
A
Laghi
Franco
F
Mikrut
Kathleen
K
Carey
Roberta B
RB
Budinger
G R Scott
GR
D000368:Aged; D001419:Bacteria / Q000302:isolation & purification*; D016638:Critical Illness; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control; D004311:Double-Blind Method; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D010288:Parenteral Nutrition / Q000379:methods*; D018410:Pneumonia, Bacterial / Q000382:microbiology / Q000517:prevention & control; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects; D013011:Sorbic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013270:Stomach / Q000187:drug effects* / Q000382:microbiology
D013011:Sorbic Acid