Acknowledgement
The authors would like to thank nutrition support team members and nurses of the intensive care unit for their critical review of the study as well as many patients who participated in this research.
References
- Heyland DK, Schroter-Noppe D, Drover JW, Jain M, Keefe L, Dhaliwal R, Day A. Nutrition support in the critical care setting: current practice in canadian ICUs--opportunities for improvement? JPEN J Parenter Enteral Nutr 2003;27:74-83. https://doi.org/10.1177/014860710302700174
- Kreymann KG, Berger MM, Deutz NE, Hiesmayr M, Jolliet P, Kazandjiev G, Nitenberg G, van den Berghe G, Wernerman J, DGEM (German Society for Nutritional Medicine)Ebner C, Hartl W, Heymann C, Spies CESPEN (European Society for Parenteral and Enteral Nutrition). ESPEN guidelines on enteral nutrition: intensive care. Clin Nutr 2006;25:210-23. https://doi.org/10.1016/j.clnu.2006.01.021
- Heyland DK, Konopad E, Alberda C, Keefe L, Cooper C, Cantwell B. How well do critically ill patients tolerate early, intragastric enteral feeding? Results of a prospective, multicenter trial. Nutr Clin Pract 1999;14:23-8. https://doi.org/10.1177/088453369901400105
- Whelan K. Enteral-tube-feeding diarrhoea: manipulating the colonic microbiota with probiotics and prebiotics. Proc Nutr Soc 2007;66:299-306. https://doi.org/10.1017/S0029665107005551
- Pesola GR, Hogg JE, Eissa N, Matthews DE, Carlon GC. Hypertonic nasogastric tube feedings: do they cause diarrhea? Crit Care Med 1990;18:1378-82. https://doi.org/10.1097/00003246-199012000-00014
- Barrett JS, Shepherd SJ, Gibson PR. Strategies to manage gastrointestinal symptoms complicating enteral feeding. JPEN J Parenter Enteral Nutr 2009;33:21-6. https://doi.org/10.1177/0148607108325073
- van Tilburg MA, Felix CT. Diet and functional abdominal pain in children and adolescents. J Pediatr Gastroenterol Nutr 2013;57:141-8. https://doi.org/10.1097/mpg.0b013e31829ae5c5
- Staudacher HM, Whelan K, Irving PM, Lomer MC. Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPs) versus standard dietary advice in patients with irritable bowel syndrome. J Hum Nutr Diet 2011;24:487-95. https://doi.org/10.1111/j.1365-277X.2011.01162.x
- de Roest RH, Dobbs BR, Chapman BA, Batman B, O'Brien LA, Leeper JA, Hebblethwaite CR, Gearry RB. The low FODMAP diet improves gastrointestinal symptoms in patients with irritable bowel syndrome: a prospective study. Int J Clin Pract 2013;67:895-903. https://doi.org/10.1111/ijcp.12128
- Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology 2014;146:67-75.e5. https://doi.org/10.1053/j.gastro.2013.09.046
- Barrett JS, Gearry RB, Muir JG, Irving PM, Rose R, Rosella O, Haines ML, Shepherd SJ, Gibson PR. Dietary poorly absorbed, short-chain carbohydrates increase delivery of water and fermentable substrates to the proximal colon. Aliment Pharmacol Ther 2010;31:874-82. https://doi.org/10.1111/j.1365-2036.2010.04237.x
- Ong DK, Mitchell SB, Barrett JS, Shepherd SJ, Irving PM, Biesiekierski JR, Smith S, Gibson PR, Muir JG. Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome. J Gastroenterol Hepatol 2010;25:1366-73. https://doi.org/10.1111/j.1440-1746.2010.06370.x
- Halmos EP, Muir JG, Barrett JS, Deng M, Shepherd SJ, Gibson PR. Diarrhoea during enteral nutrition is predicted by the poorly absorbed short-chain carbohydrate (FODMAP) content of the formula. Aliment Pharmacol Ther 2010;32:925-33. https://doi.org/10.1111/j.1365-2036.2010.04416.x
- Chang SJ, Huang HH. Diarrhea in enterally fed patients: blame the diet? Curr Opin Clin Nutr Metab Care 2013;16:588-94. https://doi.org/10.1097/MCO.0b013e328363bcaf
- Cho MR, Lee JS, Kim MC. Effects of fiber in enteral formula on stool frequency. J Korean Soc Parenter Enter Nutr 2013;5:31-5.
- Lee H. Practical guidelines for enteral nutrition support. J Neurocrit Care 2010;3:115-7.
- Harris S, Naina HV, Kuppachi S. Look, feel, listen or look, listen, feel? Am J Med 2007;120:e3. https://doi.org/10.1016/j.amjmed.2006.05.064
- Whelan K, Judd PA, Taylor MA. Assessment of fecal output in patients receiving enteral tube feeding: validation of a novel chart. Eur J Clin Nutr 2004;58:1030-7. https://doi.org/10.1038/sj.ejcn.1601927
- Oudemans-van Straaten HM, Bosman RJ, Treskes M, van der Spoel HJ, Zandstra DF. Plasma glutamine depletion and patient outcome in acute ICU admissions. Intensive Care Med 2001;27:84-90. https://doi.org/10.1007/s001340000703
- Reintam A, Parm P, Kitus R, Kern H, Starkopf J. Gastrointestinal symptoms in intensive care patients. Acta Anaesthesiol Scand 2009;53:318-24. https://doi.org/10.1111/j.1399-6576.2008.01860.x
- Mentec H, Dupont H, Bocchetti M, Cani P, Ponche F, Bleichner G. Upper digestive intolerance during enteral nutrition in critically ill patients: frequency, risk factors, and complications. Crit Care Med 2001;29:1955-61. https://doi.org/10.1097/00003246-200110000-00018
- Whelan K, Judd PA, Preedy VR, Taylor MA. Enteral feeding: the effect on faecal output, the faecal microflora and SCFA concentrations. Proc Nutr Soc 2004;63:105-13. https://doi.org/10.1079/PNS2003317
- Dorman BP, Hill C, McGrath M, Mansour A, Dobson D, Pearse T, Singleton J, Al-Omoush A, Barry M, Colongon AR, Perez M, Fitzgerald D, Zabala M. Bowel management in the intensive care unit. Intensive Crit Care Nurs 2004;20:320-9. https://doi.org/10.1016/j.iccn.2004.09.004
- Mueller CM. The ASPEN Adult Nutrition Support Core Curriculum. Silver Spring (MD): American Society for Parenteral and Enteral Nutrition; 2017. p.230-231, 268.
- Thorson MA, Bliss DZ, Savik K. Re-examination of risk factors for non-Clostridium difficile-associated diarrhoea in hospitalized patients. J Adv Nurs 2008;62:354-64. https://doi.org/10.1111/j.1365-2648.2008.04607.x
- Homann HH, Kemen M, Fuessenich C, Senkal M, Zumtobel V. Reduction in diarrhea incidence by soluble fiber in patients receiving total or supplemental enteral nutrition. JPEN J Parenter Enteral Nutr 1994;18:486-90. https://doi.org/10.1177/0148607194018006486
- Spapen H, Diltoer M, Van Malderen C, Opdenacker G, Suys E, Huyghens L. Soluble fiber reduces the incidence of diarrhea in septic patients receiving total enteral nutrition: a prospective, double-blind, randomized, and controlled trial. Clin Nutr 2001;20:301-5. https://doi.org/10.1054/clnu.2001.0399
- Nakao M, Ogura Y, Satake S, Ito I, Iguchi A, Takagi K, Nabeshima T. Usefulness of soluble dietary fiber for the treatment of diarrhea during enteral nutrition in elderly patients. Nutrition 2002;18:35-9. https://doi.org/10.1016/S0899-9007(01)00715-8
- Yoon SR, Lee JH, Lee JH, Na GY, Lee KH, Lee YB, Jung GH, Kim OY. Low-FODMAP formula improves diarrhea and nutritional status in hospitalized patients receiving enteral nutrition: a randomized, multicenter, double-blind clinical trial. Nutr J 2015;14:116. https://doi.org/10.1186/s12937-015-0106-0
- Trabal J, Leyes P, Hervas S, Herrera M, de Tallo Forga M. Factors associated with nosocomial diarrhea in patients with enteral tube feeding. Nutr Hosp 2008;23:500-4.
- AlKhawaja S. Diarrhea in critically Ill patient. EC Nutr 2017;9:105-15.
- Lewis K, Alqahtani Z, Mcintyre L, Almenawer S, Alshamsi F, Rhodes A, Evans L, Angus DC, Alhazzani W. The efficacy and safety of prokinetic agents in critically ill patients receiving enteral nutrition: a systematic review and meta-analysis of randomized trials. Crit Care 2016;20:259. https://doi.org/10.1186/s13054-016-1441-z
- Guenter PA, Settle RG, Perlmutter S, Marino PL, DeSimone GA, Rolandelli RH. Tube feeding-related diarrhea in acutely Ill patients. JPEN J Parenter Enteral Nutr 1991;15:277-80. https://doi.org/10.1177/0148607191015003277
- Williams P, Cotta MO, Roberts JA. Pharmacokinetics/pharmacodynamics of β-lactams and therapeutic drug monitoring: from theory to practical issues in the intensive care unit. Semin Respir Crit Care Med 2019;40:476-87. https://doi.org/10.1055/s-0039-1693498
- McFarland LV, Surawicz CM, Greenberg RN, Elmer GW, Moyer KA, Melcher SA, Bowen KE, Cox JL. Prevention of beta-lactam-associated diarrhea by Saccharomyces boulardii compared with placebo. Am J Gastroenterol 1995;90:439-48.
- Lagace-Wiens P, Rubinstein E. Adverse reactions to β-lactam antimicrobials. Expert Opin Drug Saf 2012;11:381-99. https://doi.org/10.1517/14740338.2012.643866