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Impact of Soluble Fiber in the Microbiome and Outcomes in Critically Ill Patients

  • Carla Venegas-BorsellinoEmail author
  • Minkyung Kwon
Gastroenterology, Critical Care, and Lifestyle Medicine (SA McClave, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Gastroenterology, Critical Care, and Lifestyle Medicine

Abstract

Purpose of Review

To discuss the controversy over the effect of dietary fiber (DF) on (1) outcomes in critical illness, (2) microbiome and metabolic homeostasis, and (3) current evidence and guidelines regarding supplementation in critically ill patients.

Recent Findings

In healthy individuals, consumption of DF is widely known as a long-term protecting factor against colon cancer, cardiovascular disease, and other metabolic disorders like obesity, type 2 diabetes, and fatty liver disease; in hospitalized patients, DF may have a beneficial effect in the incidence of diarrhea, infections, and length of stay. But, what does that mean for critically ill patients? What is the recommended DF intake and what are current guidelines?

Summary

There are many confounding factors that limit the evidence of beneficial effects from fiber supplementation in critically ill patients, including the side effects critical care therapies can have on gut microbiota, but after extrapolating data from healthy and hospitalized non-critical patients and considering that its administration appears to be safe, it may be wise to administer fiber-containing enteral feedings in ICU patients. Analysis of those confounders requires future research.

Keywords

Dietary fiber Critical illness Microbiome Inflammatory response Small chain fatty acids 

Notes

Compliance with Ethical Standards

Conflict of Interest

Carla Venegas-Borsellino and Minkyung Kwon declare they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Critical Care MedicineMayo ClinicJacksonvilleUSA
  2. 2.Department of Pulmonary MedicineMayo ClinicJacksonvilleUSA

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