Effects of different dietary fiber supplement strategies on incidence of acute gastrointestinal injury in ICU patients: A prospective observational study

Objective This study aimed to explore the effects of dietary fiber (DF) supplement strategies on the incidence of acute gastrointestinal injury (AGI) in critically ill patients. Design A prospective observational study. Setting The study was conducted in the First Affiliated Hospital of Soochow University from April 2021 to March 2023. Methods 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 were evaluated on the day 5 (D5) and day 7 (D7) after intensive care unit admission. Results A total of 179 patients were included in the study. The LCTM yielded a four-trajectories of models, named; Sustained Low – Group, Slowly Rising – Group, Early Supplement & Slowly Rising – Group and Rapidly Rising – Group, respectively. The incidences of AGI on D5 and D7 were 51.4 % and 40.0 %, respectively. There was an increased risk in the grade of AGI in the Sustained Low – Group compared with the Rapidly Rising – Group on D5 [odds ratio (OR), 4.8; 95 % confidence interval (CI), 1.9–12.1] and D7 (OR, 12.0; 95 % CI, 3.9–37.0); and an increased risk in the Slowly Rising – Group on D5 (OR, 3.6; 95 % CI, 1.3–9.9). Conclusion The supplement of DF in critically ill patients may be insufficient and the incidence of AGI is high. Sustained low and slow rising DF supplement may be associated with an increased risk in the AGI. Implications for clinical practice The clinical staff could focus on the supplementation of not only the three macronutrients, but also DF in critically ill patients.