Blenderized Enteral Nutrition Diet Study: Feasibility, Clinical, and Microbiome Outcomes of Providing Blenderized Feeds Through a Gastric Tube in a Medically Complex Pediatric Population
Blenderized Enteral Nutrition Diet Study: Feasibility, Clinical, and Microbiome Outcomes of Providing Blenderized Feeds Through a Gastric Tube in a Medically Complex Pediatric Population
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DOI：
10.1002/jpen.1049
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发表时间：
2018-08-01
影响因子：
3.4
通讯作者：
Marcon, Margaret
中科院分区：
文献类型：
--
作者：
Gallagher, Kelsey;Flint, Annika;Marcon, Margaret
背景慢性病患儿经常需要通过胃造口管（G管）喂养。商业配方最常用于肠内喂养;然而，护理人员一直要求混合管饲（BTF）作为替代方案。本研究的目的是评估在医学上复杂的儿科人群中使用BTF的可行性，并评估其对临床结果的影响，以及microbiota.MethodsTwenty儿科参与者。参与者依赖G管，每天75%的能量需求来自商业配方。在4周内，参与者从商业配方过渡到BTF，并监测6个月的营养摄入量，胃肠道症状，口服喂养，药物使用和护理人员感知的变化。肠道菌群的变化进行了监测16 S rDNA为基础的sequencing.ResultsTransition到BTF是可行的17名参与者，1名参与者过渡到口服饲料。与商业配方奶粉相比，参与者需要多50%的卡路里来维持他们的体重指数。BTF微量营养素含量上级优于商品配方。BTF组呕吐和抑酸剂使用率显著降低。粪便的一致性和频率保持不变，而粪便软化剂的使用增加。粪便样品中细菌的多样性和丰富度显著增加，而变形菌门的相对丰度下降。照顾者更满意BTFs，一致表示，他们会建议BTFs.ConclusionInitiation和维护BTFs不仅是可行的，在医学上复杂的儿科人群，但也可以与改善临床结果和增加肠道细菌多样性。
BackgroundChronically ill children often require feeding via gastrostomy tubes (G-tubes). Commercial formula is most commonly used for enteral feeding; however, caregivers have been requesting blenderized tube feeds (BTFs) as an alternative. The objective of this study was to evaluate the feasibility of using BTFs in a medically complex pediatric population and assess their impact on clinical outcomes, as well as the microbiota.MethodsTwenty pediatric participants were included. Participants were G-tube dependent and receiving 75% of their daily energy requirements from commercial formula. Over 4 weeks, participants were transitioned from commercial formula to BTF and were monitored for 6 months for changes in nutrient intake, gastrointestinal symptoms, oral feeding, medication use, and caregiver perceptions. Changes to intestinal microbiota were monitored by 16S rDNA-based sequencing.ResultsTransition onto BTF was feasible in 17 participants, and 1 participant transitioned to oral feeds. Participants required 50% more calories to maintain their body mass index while on BTFs compared with commercial formula. BTF micronutrient content was superior to commercial formula. Prevalence of vomiting and use of acid-suppressive agents significantly decreased on BTFs. Stool consistency and frequency remained unchanged, while stool softener use increased. The bacterial diversity and richness in stool samples significantly increased, while the relative abundance of Proteobacteria decreased. Caregivers were more satisfied with BTFs and unanimously indicated they would recommend BTFs.ConclusionInitiation and maintenance of BTFs is not only feasible in a medically complex pediatric population but can also be associated with improved clinical outcomes and increased intestinal bacterial diversity.