title: Microbial cell preparation in enteral feeding in critically ill patients: A randomized, double-blind, placebo-controlled clinical trial.
abstract: Gut failure is a common condition in critically ill patients in the intensive care unit (ICU). Enteral feeding is usually the first line of choice for nutrition support in critically ill patients. However, enteral feeding has its own set of complications such as alterations in gut transit time and composition of gut eco-culture. The primary aim of this study was to investigate the effect of microbial cell preparation on the return of gut function, white blood cell count, C-reactive protein levels, number of days on mechanical ventilation, and length of stay in ICU. A consecutive cohort of 60 patients admitted to the ICU in University Malaya Medical Centre requiring enteral feeding were prospectively randomized to receive either treatment (n = 30) or placebo (n = 30). Patients receiving enteral feeding supplemented with a course of treatment achieved a faster return of gut function and required shorter duration of mechanical ventilation and shorter length of stay in the ICU. However, inflammatory markers did not show any significant change in the pretreatment and posttreatment groups. Overall, it can be concluded that microbial cell preparation enhances gut function and the overall clinical outcome of critically ill patients receiving enteral feeding in the ICU.
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Ausama A
authors.initials: AA
authors.lastname: Malik
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Retnagowri
authors.initials: R
authors.lastname: Rajandram
authors.affiliation: Department of Dietetics, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Pei Chien
authors.initials: PC
authors.lastname: Tah
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Vineya-Rai
authors.initials: VR
authors.lastname: Hakumat-Rai
authors.affiliation: Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia. Electronic address: mdskfc@gmail.com.
authors.forename: Kin-Fah
authors.initials: KF
authors.lastname: Chin
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D016638:Critical Illness / Q000628:therapy*; D004311:Double-Blind Method; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D005767:Gastrointestinal Diseases / Q000628:therapy*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D019936:Probiotics / Q000008:administration & dosage*; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D013997:Time Factors
chemical_list: D002097:C-Reactive Protein
keywords: Clinical outcome; Critically ill; Enteral feeding; Gut function; Microbial cell preparation