Objective: The aim was to infer the association between the presence or absence of a nutritional assessment and nutritional management outcomes for critically ill patients in the ICU.

Subjects and Methods: We enrolled critically ill patients (>7 days’ stay in the ICU) from Japan in the International Nutrition Survey 2014. Patients were divided in two groups according to the presence or absence of nutritional assessment. Patient characteristics (e.g., reason for admission and BMI), nutritional management outcomes (energy and protein intake and days to start of enteral feeding), and prognostic data were compared between the two groups by univariate and multivariate analyses.

Results: Of the total 329 patients enrolled, 67.7% had a nutritional assessment (assessed group). Energy intake was significantly higher in the assessed group than in the non-assessed group (median [interquartile range] 12.5 [6.2, 18.0] kcal/kg/day vs. 8.0 [2.1, 13.1] kcal/kg/day, respectively; p<0.01). The number of days to the start of enteral feeding was shorter in the assessed group than in the non-assessed group (median [IQR] 1.31 [0.75, 2.44] days vs. 2.65 [1.26, 4.05] days; p<0.01).

Conclusions: Having a nutritional assessment is associated with better nutritional management outcomes for critically ill patients in the ICU such as higher nutrition intake and early initiation of enteral feeding.

Objective: The aim of this prospective observational study was to compare the effects of a formula containing pectin as dietary fibers and peptides as a source of amino acids (HINE E-GEL^®: HE) and the effect of a formula containing guar gum as dietary fibers and proteins as a source of amino acids (polymeric formula: PF) on gut microbiota in patients using a proton pump inhibitors (PPI).

Subjects and Methods: We selected 26 patients who had been receiving intragastric tube feeding with a PPI for at least 2 weeks after the onset of stroke. They were divided into two groups to receive either HE (n=12) or PF (n=14). The composition of the fecal microbiota and the fecal metabolc products were evaluated using terminal restriction fragment length polymorphism(T-RFLP) analysis before and after enteral nutrition.

Results: There was a significant decrease in Clostridium cluster XI bacteria in both the HE and PF groups after observation period of 2 weeks. SCFA tended to be higher, while the fecal pH tended to be lower, in the HE group compared with the PF group.

Conclusion: These results indicate that dietary fiber-containing enteral nutrition plays a role in the suppression of Clostoridioides difficile infection in patients in the acute stage of stroke who use a PPI. The findings also suggest that HE maintains a lower pH environment beneficial for gut microbiota compared with PF.