EC Nutrition

Research Article Volume 18 Issue 4 - 2023

A Prospective Pilot Study to Monitor the Impact of a High Fiber ‘Enteral Formula with Food-Derived Ingredients’ on Fecal Short-Chain Fatty Acid Concentrations in Children Admitted to Intensive Care with Sepsis

Graeme O'Connor1*, Yuxin Sun2, Breeana Gardiner1, Grace Audu3, Mona Bajaj-Elliott2 and Simon Eaton4

1Great Ormond Street Hospital, Dietetics Department, London, United Kingdom
2Infection, Immunity and Inflammation Department, Institute of Child Health, University College London, United Kingdom
3Infection, Immunity and Inflammation Department, Great Ormond Street Institute of Child Health, University College London, United Kingdom
4Developmental Biology and Cancer Department, UCL Great Ormond Street Institute of Child Health, University College London, United Kingdom

*Corresponding Author: Dr Graeme O'Connor, Great Ormond Street Hospital, Dietetics Department, London, United Kingdom.
Received: April 01, 2023; Published: April 11, 2023

Background: Dietary fiber undergoes fermentation by the microbiota to produce intestinal short-chain fatty acids (SCFA). The synergistic relationship between the host and SCFA inhibits the colonization of pathogenic microorganisms. Sepsis is the leading cause of mortality in hospitalized children. Paradoxically, antibiotic management of sepsis can increase infections by causing dysbiosis. This study assessed the impact of an ‘enteral formula with food-derived ingredients’ on feed tolerance and fecal SCFA concentrations in children admitted to intensive care with sepsis.

Methods: Children were switched to Compleat®Paediatric, which contains 1g fiber/100 ml (Nestle Health Science). Stool consistency and frequency were monitored. Stool samples were collected at baseline before the formula switch and weekly thereafter to measure SCFA concentrations (acetate, butyrate, and propionate). A Wilcoxon Signed-Rank test was used to measure the change in SCFA concentrations.

Results: Twenty children switched to a high-fiber enteral formula containing food-derived ingredients. All children were prescribed at least one antibiotic, with 25% of children treated with more than two antibiotics. After the formula switch stool frequency reduced from 2.6 (± 1.08SD) at baseline to 1.2 (± 0.45SD) (p < 0.004). Similarly, stool consistency significantly improved from 6.6 (± 0.4SD) at baseline compared to 3.6 (± 0.4SD) (p < 0.001). Fecal propionate and butyrate concentrations were maintained during the children’s time in intensive care.

Conclusion: Children admitted to intensive care with sepsis may benefit from a high fiber ‘enteral formula with food-derived ingredients’, which may mitigate the gastrointestinal symptoms associated with antibiotic dysbiosis by preserving intestinal SCFA concentrations.

Keywords: Pediatric Intensive Care Unit; Sepsis; Enteral Formula with Food-Derived Ingredients; Enteral Feed Intolerance; Short-Chain Fatty Acids

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Graeme O’Connor., et al. "A Prospective Pilot Study to Monitor the Impact of a High Fiber ‘Enteral Formula with Food-Derived Ingredients’ on Fecal Short-Chain Fatty Acid Concentrations in Children Admitted to Intensive Care with Sepsis". EC Nutrition 18.4 (2023): 17-27.