Carla Venegas-Borsellino1, Minkyung Kwon2,3. 1. Department of Critical Care Medicine, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA. Venegas-Borsellino.Carla@mayo.edu. 2. Department of Critical Care Medicine, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA. 3. Department of Pulmonary Medicine, Mayo Clinic, Jacksonville, FL, 32224, USA.
Abstract
PURPOSE OF REVIEW: To discuss the controversy over the effect of dietary fiber (DF) on (1) outcomes in critical illness, (2) microbiome and metabolic homeostasis, and (3) current evidence and guidelines regarding supplementation in critically ill patients. RECENT FINDINGS: In healthy individuals, consumption of DF is widely known as a long-term protecting factor against colon cancer, cardiovascular disease, and other metabolic disorders like obesity, type 2 diabetes, and fatty liver disease; in hospitalized patients, DF may have a beneficial effect in the incidence of diarrhea, infections, and length of stay. But, what does that mean for critically ill patients? What is the recommended DF intake and what are current guidelines? There are many confounding factors that limit the evidence of beneficial effects from fiber supplementation in critically ill patients, including the side effects critical care therapies can have on gut microbiota, but after extrapolating data from healthy and hospitalized non-critical patients and considering that its administration appears to be safe, it may be wise to administer fiber-containing enteral feedings in ICU patients. Analysis of those confounders requires future research.
PURPOSE OF REVIEW: To discuss the controversy over the effect of dietary fiber (DF) on (1) outcomes in critical illness, (2) microbiome and metabolic homeostasis, and (3) current evidence and guidelines regarding supplementation in critically illpatients. RECENT FINDINGS: In healthy individuals, consumption of DF is widely known as a long-term protecting factor against colon cancer, cardiovascular disease, and other metabolic disorders like obesity, type 2 diabetes, and fatty liver disease; in hospitalized patients, DF may have a beneficial effect in the incidence of diarrhea, infections, and length of stay. But, what does that mean for critically illpatients? What is the recommended DF intake and what are current guidelines? There are many confounding factors that limit the evidence of beneficial effects from fiber supplementation in critically illpatients, including the side effects critical care therapies can have on gut microbiota, but after extrapolating data from healthy and hospitalized non-critical patients and considering that its administration appears to be safe, it may be wise to administer fiber-containing enteral feedings in ICU patients. Analysis of those confounders requires future research.
Authors: K G Kreymann; M M Berger; N E P Deutz; M Hiesmayr; P Jolliet; G Kazandjiev; G Nitenberg; G van den Berghe; J Wernerman; C Ebner; W Hartl; C Heymann; C Spies Journal: Clin Nutr Date: 2006-05-11 Impact factor: 7.324
Authors: Marc Gh Besselink; Hjalmar C van Santvoort; Erik Buskens; Marja A Boermeester; Harry van Goor; Harro M Timmerman; Vincent B Nieuwenhuijs; Thomas L Bollen; Bert van Ramshorst; Ben Jm Witteman; Camiel Rosman; Rutger J Ploeg; Menno A Brink; Alexander Fm Schaapherder; Cornelis Hc Dejong; Peter J Wahab; Cees Jhm van Laarhoven; Erwin van der Harst; Casper Hj van Eijck; Miguel A Cuesta; Louis Ma Akkermans; Hein G Gooszen Journal: Lancet Date: 2008-02-14 Impact factor: 79.321
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Authors: Audrey Machado Dos Reis; Ana Valéria Fruchtenicht; Sérgio Henrique Loss; Luis Fernando Moreira Journal: Rev Bras Ter Intensiva Date: 2018 Jul-Sept