• Chunfang Qiu, Chuanxi Chen, Weixing Zhang, Qiuye Kou, Shengnan Wu, Lixin Zhou, Jiyun Liu, Gang Ma, Juan Chen, Minying Chen, Hua Luo, Xiaofei Zhang, Jianbo Lai, Zhihui Yu, Xiaochun Yu, Wei Liao, Xiangdong Guan, and Bin Ouyang.
• 1 Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China.
• Jpen Parenter Enter. 2017 Jul 1; 41 (5): 785-795.

BackgroundImprovement of fat digestion and absorption was supposed to relieve feeding intolerance. This trial aimed to evaluate the effect of a fat-modified enteral formula on feeding tolerance in critically ill patients.Materials And MethodsThis trial was conducted in 7 hospitals in China. In total, 144 intensive care unit (ICU) patients with estimated need of enteral nutrition (EN) for at least 5 days were randomly given fat-modified enteral formula containing medium-chain triglycerides (MCT), carnitine, and taurine (interventional feed group, n = 71) or standard enteral formula (control feed group, n = 73). EN intake, feeding intolerance (diarrhea, vomiting, gastric retention, and abdominal distension) and outcomes (mechanical ventilator-free days of 28 days, length of ICU stay, length of hospital stay, and in-hospital mortality) were collected.ResultsDaily calories and protein intake were increased in the interventional feed group compared with the control feed group ( P < .01). Total incidence of feeding intolerance was 42.3% in the interventional feed group and 65.7% in the control feed group ( P < .001). Daily incidence of feeding intolerance was 11.3%, 18.3%, 14.1%, 25.4%, and 26.1% in the interventional feed group and 31.5%, 32.9%, 34.2%, 34.2%, and 30.4% in the control feed group from study days 1-5 ( P = .0083). Incidence of feeding intolerance without abdominal distention was 32.9% in the interventional feed group and 49.3% in the control feed group ( P = .047), while the incidence of abdominal distension was 26.8% in the interventional feed group and 43.8% in the control feed group ( P = .03). No significant differences existed in outcomes between the 2 groups.ConclusionsThe fat-modified enteral formula containing MCT, carnitine, and taurine may improve feeding tolerance in critically ill patients.

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