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| 1 | Effect of fiber supplementation on the microbiota in critically ill patients显示文摘AIM:To determine tolerance to fiber supplementation of semi-elemental tube feeds in critically ill patients and measure its effect on colonic microbiota and fermentation.METHODS:Thirteen intensive care unit patients receiving jejunal feeding with a semi-elemental diet for predominantly necrotizing pancreatitis were studied.The study was divided into 2 parts:first,short-term (3-9 d)clinical tolerance and colonic fermentation as assessed by fecal short chain fatty acid(SCFA)concentrations and breath hydrogen and methane was measured in response to progressive fiber supplementation increasing from 4 g tid up to normal requirement levels of 8 g tid;second,4 patients with diarrhea were studied for 2-5 wk with maximal supplementation to additionally assess its influence on fecal microbiota quantitated by quantitative polymerase chain reaction (qPCR)of microbial 16S rRNA genes and Human Intestinal Tract Chip(HITChip)microarray analysis.Nearly all patients were receiving antibiotics(10/13)and acid suppressants(11/13)at some stage during the studies.RESULTS:In group 1,tolerance to progressive fiber supplementation was good with breath hydrogen and methane evidence(P=0.008 and P<0.0001,respectively)of increased fermentation with no exacerbation of abdominal symptoms and resolution of diarrhea in 2 of 4 patients.In group 2 before supplementation,fecal microbiota mass and their metabolites,SCFA,were dramatically lower in patients compared to healthy volunteers.From qPCR and HITChip analyses we calculated that there was a 97%reduction in the predominant potential butyrate producers and starch degraders.Following 2-5 wk of fiber supplementation there was a significant increase in fecal SCFA(acetate 28.4±4.1μmol/g to 42.5±3.1μmol/g dry weight,P=0.01;propionate 1.6±0.5 vs 6.22±1.1,P=0.006 and butyrate 2.5±0.6 vs 5.9±1.1,P=0.04)and microbial counts of specific butyrate producers,with resolution of diarrhea in 3 of 4 patients.CONCLUSION:Conventional management of critically ill patients,which includes the use of elemental diets and broad-spectrum antibiotics,was associated with gross suppression of the colonic microbiota and their production of essential colonic fuels,i.e.,SCFA.Our investigations show that fiber supplementation of the feeds has the potential to improve microbiota mass and function,thereby reducing the risks of diarrhea due to dysbiosis. | Stephen JD O'Keefe Junhai Ou James P DeLany Scott Curry Erwin Zoetendal H Rex Gaskins Scott Gunn | 2011 | World Journal of Gastrointestinal Pathophysiology2011，2，6： | 3 |
| 2 | Biomechanical evaluation of the stability of thoracolumbar burst fractures显示文摘 | James KS Wenger KH Sclegel JD | 1994 | Spine1994，19，： | 1 |
| 3 | Intraventricular cerebrospinal fluid antibiotic concentrations in patients with intraventricular infections 显示文摘 | James HE Wilson HD Connor JD | 1982 | Neurosurgery1982，11，： | 1 |
| 4 | Diagnostic utility of renal cell carcinoma marker in cytopathology显示文摘 | Gokden N Mukunyadzi P James JD | 2003 | Appl Immunohistochem Mol Morphol2003，11，2： | 1 |
| 5 | The mechanical properties of fast and slow skeletal muscles of the mouse in re-lation to their locomotory function显示文摘 | James RS Altringham JD Goldspink DF | 1995 | J Exp Biol1995，198，2： | 1 |
| 6 | Mechanisms of cerebral edema in traumatic brain injury: Therapeutic developments 显示文摘 | James JD Robert V | 2010 | Opin Neurol2010，23，3： | 1 |
| 7 | Biomechanical evalu- ation of the stability of thoracolumbar burst fractures 显示文摘 | James KS Wenger KH Schlegel JD | 1994 | Spine1994，19，15： | 1 |
| 8 | Palliative care among chumash Peo-ple显示文摘 | James D Adams JD Garcia G | 2005 | ECAM2005，2，2： | 1 |
| 9 | The duration of lochia 显示文摘 | LW Oppenheimer EA Sherriff JD Goodman D Shah CE James | 1986 | Br J Obstet Gynaecol1986，93，7： | 1 |
| 10 | Mutational analysis of the,DNA binding, dimerization, an d transcriptional activation do-mains of MEF2C显示文摘 | Molkentin JD Brian LB James FM | 1996 | Mol Cell Biol1996，16，6： | 1 |
| 11 | Zidovudine bioavailability and linear pharmacokinetics in female B6C3F1 mice显示文摘 | Trang JM Prejean JD James RH | 1993 | Drug Metab Dispos1993，21，： | 1 |
| 12 | Low Birth Weight Across Generations显示文摘 | James WC Richard JD Nikhil Gp | 2003 | Matern Child Health J2003，7，4： | 1 |
| 13 | Palliative Care Among Chumash People显示文摘 | James D Adams JD Garcia C | 2005 | ECAM2005，2，2： | 1 |
| 14 | 3D coronary reconstruction from routine single-plane coronary angiograms:Clinical validation and quantitative analysis of the right coronary artery in 100 patients显示文摘 | Messenger JC Chen James SY Carroll JD | 2000 | The International Journal of Cardiac Imaging2000，16，6： | 1 |
| 15 | Biomechanical of the stability of thoracolumbar burst fracturres 显示文摘 | James Ks Wenger KH Schlegel JD | 1994 | Spine1994，19，： | 1 |
| 16 | Biomechanical evaluation of the stability of thoracolumbar burst fractures 显示文摘 | James KS Wenger KH Schlegel JD | 1994 | Spine1994，19，： | 1 |
| 17 | Biomechanieal evaluation of the stability of thoraeolumbar burnt fractures显示文摘 | James KS Wenger kh Schlegel JD | 1994 | Spine1994，19，： | 1 |
| 18 | Biomechanical evaluation of the stability of thoracolumbar burst fractures 显示文摘 | James KS Wenger KH Schlegel JD | 1994 | Spine1994，19，： | 1 |
| 19 | Effect of the implantable left ventricular assist device on neuroendocrine activation in heart failure显示文摘 | James KB McCarthy PM Thomas JD | 1995 | Circulation1995，92，： | 1 |
| 20 | Biomechani-calevaluation of the stability of the thoracolumbar burst fracture 显示文摘 | James KS Wenger KH Schlegel JD | 1994 | Spine1994，19，15： | 1 |
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