Liu, Ting, Liu, Bin, Jiang, Yi-qing, Ojo, Omorogieva ORCID: 0000-0003-0071-3652 , Jiang, Xiao-song, Wang, Yu-yu, Wang, Can and Wang, Xiao-hua (2024) Effects of different dietary fiber supplement strategies on incidence of acute gastrointestinal injury in ICU patients: a prospective observational study. Intensive and Critical Care Nursing:103673. ISSN 0964-3397 (doi:https://doi.org/10.1016/j.iccn.2024.103673)

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Abstract

Background: Insufficient dietary fiber (DF) supplement is closely associated with adverse clinical outcomes in critically ill patients which has not been paid enough attention in China. The amount of DF supplement in critical settings is low and inconsistent. This study aimed to explore the associations between trajectories of DF supplement and the incidence of acute gastrointestinal injury (AGI) and other clinical outcomes.
Methods: This was a prospective observational study conducted from April 2021 to March 2023. Using a five-day dietary log counted the amount of DF supplement. The best fitting trajectories of DF supplement were determined based on the latent class trajectory modelling (LCTM). The data of AGI grade were evaluated on the day 5 (D5) and day 7 (D7) after ICU admission. The mortality of ICU and one-month were collected.
Results: A total of 179 patients were included in the study. The LCTM yielded a four- trajectories of models, named; sustained low (SL), slowly rising (SR), early supplement and slowly rising (ESR) and rapidly rising (RR) groups, respectively. The incidence of AGI on D5, D7 and one-month mortality were 51.39%, 40.0% and 15.1%, respectively. Taking the RR group as reference, the SL group had significantly higher risk in the incidence of AGI on D5 (OR, 3.30; 95% CI, 1.15 - 9.50; P = 0.017) and D7 (OR, 16.79; 95% CI, 3.96 - 71.14; P < 0.001); the SR group had a significant association with one-month mortality (OR, 9.62; 95% CI, 1.04 - 88.73; P = 0.046).
Conclusion: Early, consistent and sufficient dose of DF supplementation significantly reduce the risk of the incidence of AGI and one-month mortality in critically ill patients.
Implications for clinical practice: In order to improve clinical outcomes, critically ill patients could be provided an early, consistent and sufficient dietary information on DF supplement.

Item Type:	Article
Uncontrolled Keywords:	dietary fiber; acute gastrointestinal injury; mortality; critically ill patients
Subjects:	R Medicine > R Medicine (General) R Medicine > RT Nursing R Medicine > RZ Other systems of medicine
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Chronic Illness and Ageing Faculty of Education, Health & Human Sciences > School of Health Sciences (HEA)
Last Modified:	29 Mar 2024 10:36
URI:	http://gala.gre.ac.uk/id/eprint/46518

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