Critical Illness

CI: Enteral Nutrition and Fiber (2011)

• Intervention
  In adult patients who are critically ill, does the addition of fiber to enteral nutrition (EN) decrease diarrhea?

  • Conclusion

    Diarrhea may be reduced in adult critically ill patients when guar gum is included in the EN regimen. The impact of other types of fiber on reducing diarrhea is unclear due to variations in the fiber combinations and amounts used in the studies.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In adult patients who are critically ill, does the addition fiber to enteral nutrition (EN) decrease diarrhea?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Chittawatanarat K, Pokawinpudisnun P, Polbhakdee Y. Mixed fibers diet in surgical ICU septic patients. Asia Pac J Clin Nutr. 2010; 19 (4): 458-464.
      • Dobb GJ, Towler SC. Diarrhoea during enteral feeding in the critically ill: a comparison of feeds with and without fibre. Intensive Care Med. 1990; 16 (4): 252-255. PMID: 2162867.
      • Emery EA, Ahmad S, Koethe JD, Skipper A, Perlmutter S, Paskin DL. Banana flakes control diarrhea in enterally fed patients. Nutr Clin Pract. 1997 Apr;12(2):72-5.
      • Hart GK, Dobb GJ. Effect of a fecal bulking agent on DIARRHEA during enteral feeding in the critically ill. J Parenter Enteral Nutr. 1988 Sep-Oct; 12 (5): 465-468. PMID: 3141642.
        
      • Rushdi TA, Pichard C, Khater YH. Control of DIARRHEA by fiber-enriched diet in ICU patients on enteral nutrition: a prospective randomized controlled trial. Clin Nutr. 2004 Dec; 23 (6): 1,344-1,352. PMID: 15556256.
      • 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 Aug; 20 (4): 301-305. PMID: 11478826.
        
  • Search Plan and Results: CI: Fiber and Enteral Nutrition 2011