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Efficacy and safety of acidified enteral formulae in tube fed patients in an intensive care unit
Thesis (MNutr (Human Nutrition))--University of Stellenbosch, 2006.
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| Format: | Thesis |
| Language: | English |
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Stellenbosch : University of Stellenbosch
2008
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| _version_ | 1867614043306459136 |
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| access_status_str | Open Access |
| author | Kruger, Jeanne-Marie |
| author2 | Labadarios, D. |
| author_browse | Kruger, Jeanne-Marie Labadarios, D. |
| author_facet | Labadarios, D. Kruger, Jeanne-Marie |
| author_sort | Kruger, Jeanne-Marie |
| collection | Thesis |
| dc_rights_str_mv | University of Stellenbosch |
| description | Thesis (MNutr (Human Nutrition))--University of Stellenbosch, 2006. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/1943 |
| institution | Stellenbosch University (South Africa) |
| language | English |
| last_indexed | 2026-06-10T12:45:45.384Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2008 |
| publishDateRange | 2008 |
| publishDateSort | 2008 |
| publisher | Stellenbosch : University of Stellenbosch |
| publisherStr | Stellenbosch : University of Stellenbosch |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/1943 Efficacy and safety of acidified enteral formulae in tube fed patients in an intensive care unit Acidified formulae in ICU patients Kruger, Jeanne-Marie Labadarios, D. Fourie, C. Nel, Hannelie University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Human Nutrition. Dissertations -- Nutrition Theses -- Nutrition Dissertations -- Dietetics Theses -- Dietetics Enteral feeding Critical care medicine Patients -- Hospital care -- Nutrition Thesis (MNutr (Human Nutrition))--University of Stellenbosch, 2006. INTRODUCTION: The primary objective was to determine whether acidified formulae (pH 3.5 and 4.5) decreased gastric and tracheal colonisation, as well as microbial contamination of the enteral feeding delivery system, compared with a non-acidified control formula (pH 6.8) in critically ill patients. Secondary objectives included tolerance of the trial formulae and mortality in relation to the administration of acidified formulas. DESIGN: The trial was a controlled, double-blinded, randomised clinical trial of three parallel groups at a single centre. METHOD: Sixty-seven mechanically ventilated, medical and surgical critically ill patients were randomised according to their APACHE II scores and included in the trial. Patients received either an acidified (pH 3.5 or 4.5) or control polymeric enteral formula via an 8-Fr nasogastric tube at a continuous rate. Daily samples were taken for microbiologic analyses of the enteral formulae at various stages of reconstitution and at 6-hour and 24-hour intervals during administration thereof (feeding bottle and delivery set). Daily patient samples included nasogastric and tracheal aspirates, haematological evaluation and gastro-intestinal tolerance. The trial period terminated when patients were extubated, transferred from the ICU, enteral nutrition became contraindicated, a patient died, or for a maximum of 21 days. RESULTS: Gastric pH showed no significant difference (p = 0.86) between the 3 feeding groups [pH 3.5 (n = 23), pH 4.5 (n = 23) and pH 6.8 (n = 21)] at baseline prior to the administration of enteral formulae. After initiation of feeds, the gastric pH decreased significantly (p< 0.0001) in the acidified formulae as compared to the control formula during the trial period. Patients who received acidified enteral formulae (pH 3.5 and 4.5) had significantly less (p < 0.0001) contamination from the feeding bottles and delivery systems in respect of Enterobacteriacea, and Enterococcus., The more acidified group (pH 3.5) showed significantly less gastric contamination (p = 0.029) with Enterobacteriacea, , but not for fungi. The 3.5 acidified group also had the lowest gastric growth in terms of colony counts (≤104) of these organisms, but not for fungi, when compared to the control group (≤105). Vomiting episodes were 22% and abdominal distension 12%, with a higher incidence in the control group. Adverse events occurred equally between the groups with a higher, but not significantly different incidence of 37% in the control group and 32% for the acidified groups. There was no evidence of gastro-intestinal bleeding in any patient. Overall, the mortality rate in this trial was 6%, with 6.5% for the acidified groups (n=46) and 4.8% for the control group (n=21), a statistically insignificant difference. CONCLUSION: Acidified enteral formulae significantly decrease gastric colonisation by preserving gastric acidity that decreases the growth of Enterobacteriaceaes organisms. Acidified formulae significantly decrease bacterial contamination of the enteral feeding system (bottle and delivery set) of Enterobacteriaceae and Enterococcus organisms. Acidified formulae are tolerated well in critically ill patients. 2008-02-05T08:19:26Z 2010-06-01T08:37:06Z 2008-02-05T08:19:26Z 2010-06-01T08:37:06Z 2006-03 Thesis http://hdl.handle.net/10019.1/1943 en University of Stellenbosch 4093223 bytes application/pdf application/pdf Stellenbosch : University of Stellenbosch |
| spellingShingle | Dissertations -- Nutrition Theses -- Nutrition Dissertations -- Dietetics Theses -- Dietetics Enteral feeding Critical care medicine Patients -- Hospital care -- Nutrition Kruger, Jeanne-Marie Efficacy and safety of acidified enteral formulae in tube fed patients in an intensive care unit |
| title | Efficacy and safety of acidified enteral formulae in tube fed patients in an intensive care unit |
| title_full | Efficacy and safety of acidified enteral formulae in tube fed patients in an intensive care unit |
| title_fullStr | Efficacy and safety of acidified enteral formulae in tube fed patients in an intensive care unit |
| title_full_unstemmed | Efficacy and safety of acidified enteral formulae in tube fed patients in an intensive care unit |
| title_short | Efficacy and safety of acidified enteral formulae in tube fed patients in an intensive care unit |
| title_sort | efficacy and safety of acidified enteral formulae in tube fed patients in an intensive care unit |
| topic | Dissertations -- Nutrition Theses -- Nutrition Dissertations -- Dietetics Theses -- Dietetics Enteral feeding Critical care medicine Patients -- Hospital care -- Nutrition |
| url | http://hdl.handle.net/10019.1/1943 |
| work_keys_str_mv | AT krugerjeannemarie efficacyandsafetyofacidifiedenteralformulaeintubefedpatientsinanintensivecareunit AT krugerjeannemarie acidifiedformulaeinicupatients |