Fat-Modified Enteral Formula Improves Feeding Tolerance in Critically Ill Patients: A Multicenter, Single-Blind, Randomized Controlled Trial.
Improvement of fat digestion and absorption was supposed to relieve feeding intolerance. This trial aimed to evaluate the effect of a fat-modified enteral formula on feeding tolerance in critically ill patients.



This trial was conducted in 7 hospitals in China. In total, 144 intensive care unit (ICU) patients with estimated need of enteral nutrition (EN) for at least 5 days were randomly given fat-modified enteral formula containing medium-chain triglycerides (MCT), carnitine, and taurine (interventional feed group, n = 71) or standard enteral formula (control feed group, n = 73). EN intake, feeding intolerance (diarrhea, vomiting, gastric retention, and abdominal distension) and outcomes (mechanical ventilator-free days of 28 days, length of ICU stay, length of hospital stay, and in-hospital mortality) were collected.



Daily calories and protein intake were increased in the interventional feed group compared with the control feed group ( P < .01). Total incidence of feeding intolerance was 42.3% in the interventional feed group and 65.7% in the control feed group ( P < .001). Daily incidence of feeding intolerance was 11.3%, 18.3%, 14.1%, 25.4%, and 26.1% in the interventional feed group and 31.5%, 32.9%, 34.2%, 34.2%, and 30.4% in the control feed group from study days 1-5 ( P = .0083). Incidence of feeding intolerance without abdominal distention was 32.9% in the interventional feed group and 49.3% in the control feed group ( P = .047), while the incidence of abdominal distension was 26.8% in the interventional feed group and 43.8% in the control feed group ( P = .03). No significant differences existed in outcomes between the 2 groups.



The fat-modified enteral formula containing MCT, carnitine, and taurine may improve feeding tolerance in critically ill patients.
1 Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China.
Chunfang
C
Qiu
1 Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China.
Chuanxi
C
Chen
2 Department of Intensive Care Unit, Peking University Shenzhen Hospital, Shenzhen, P.R. China.
Weixing
W
Zhang
3 Department of Intensive Care Unit, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China.
Qiuye
Q
Kou
4 Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen, P.R. China.
Shengnan
S
Wu
5 Department of Intensive Care Unit, The First People's Hospital of Foshan, Foshan, P.R. China.
Lixin
L
Zhou
6 Department of Intensive Care Unit, The First People's Hospital of Guangzhou, Guangzhou, P.R. China.
Jiyun
J
Liu
7 Department of Intensive Care Unit, University Cancer Center, Guangzhou, P.R. China.
Gang
G
Ma
1 Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China.
Juan
J
Chen
1 Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China.
Minying
M
Chen
2 Department of Intensive Care Unit, Peking University Shenzhen Hospital, Shenzhen, P.R. China.
Hua
H
Luo
3 Department of Intensive Care Unit, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China.
Xiaofei
X
Zhang
4 Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen, P.R. China.
Jianbo
J
Lai
5 Department of Intensive Care Unit, The First People's Hospital of Foshan, Foshan, P.R. China.
Zhihui
Z
Yu
6 Department of Intensive Care Unit, The First People's Hospital of Guangzhou, Guangzhou, P.R. China.
Xiaochun
X
Yu
7 Department of Intensive Care Unit, University Cancer Center, Guangzhou, P.R. China.
Wei
W
Liao
1 Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China.
Xiangdong
X
Guan
1 Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China.
Bin
B
Ouyang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002331:Carnitine / Q000008:administration & dosage; D002681:China / Q000453:epidemiology; D016638:Critical Illness / Q000401:mortality* / Q000628:therapy*; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage*; D004043:Dietary Fiber / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D004750:Enteral Nutrition; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage*; D001068:Feeding and Eating Disorders / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016037:Single-Blind Method; D013654:Taurine / Q000008:administration & dosage; D016896:Treatment Outcome; D014280:Triglycerides / Q000008:administration & dosage; D055815:Young Adult
D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004043:Dietary Fiber; D004044:Dietary Proteins; D005217:Fat Emulsions, Intravenous; D014280:Triglycerides; D013654:Taurine; D002097:C-Reactive Protein; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin; D002331:Carnitine
critically ill patients; enteral nutrition; fat-modified enteral formula; feeding intolerance