Abstract
Malnutrition in hospitalized children together with disturbances of the intestinal microbiota favour infectious diarrhoea and nosocomial infections.
Objectives: to demonstrate tolerance of an enteral formula containing pro-and prebiotics assessed by progression to caloric target, its safety in the PICU, and impact on intestinal microbiota.
Design Methods: 88 PICU patients between 1-3 years under mechanical ventilation and enteral feeding were randomized to receive a test formula containing probiotics, prebiotics or an isocaloric/ isoprotein control. Patients remained 7 days in the PICU and were further examined at day 14.
Results: the caloric intake was similar in both groups. The time to caloric goal was 5.1 and 5.03 for test and control groups respectively. Abdominal distension, vomiting and diarrhoea were not affected by pre-and probiotics.
Assessment of antibiotic resistant bacteria showed a trend for lower vancomycin resistant enterococci (16.4% less in the test group), whereas % of ATBr Enterobacteriaceae and Pseudomonas aeruginosa were similar between groups. Bifidobacteria counts were higher in the test group at day 14 (P=0.046). A similar trend was observed for Lactobacilli (P=0.08). The probiotic Lactobacillus paracasei NCC2461 was detected in 80 % of fecal samples in the test group; while the probiotic Bifidobacterium longum NCC3001 was detected in 17 % of cases Enterobacteria diminished 1 log in the test group (P= 0.08) whereas it did not change in the control group.
Conclusion: The use of pro-and prebiotic did not alter the tolerance of enteral feeding in the PICU, it is safe, and promotes a positive balance of the intestinal microbiota.
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Schiffrin, E., Simakachorn, N., Tongpenyai, Y. et al. 373 Safe Use of Enteral Formula Containing Pro-And Prebiotics in Pediatric Intensive Care Unit (PICU): Effect on Gut Ecology. Pediatr Res 68 (Suppl 1), 192–193 (2010). https://doi.org/10.1203/00006450-201011001-00373
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DOI: https://doi.org/10.1203/00006450-201011001-00373