Potassium sorbate reduces gastric colonization in patients receiving mechanical ventilation

• Published in: Journal of critical care 2005-09, Vol.20 (3), p.281-287
• Main Authors: Tulamait, Aiman, Laghi, Franco, Mikrut, Kathleen, Carey, Roberta B., Budinger, G.R. Scott
• Format: Article
• Language: English
• Subjects: Aged; Bacteria; Bacteria - isolation & purification; Blood; Critical Illness; Cross Infection - microbiology; Cross Infection - prevention & control; Double-Blind Method; Enteral Nutrition; Female; Gastrointestinal hemorrhage; Hospital costs; Hospitalization; Humans; Hydrogen-Ion Concentration; Male; Mechanical ventilation; Mortality; Nosocomial infection; Nosocomial infections; Nutrition; Organisms; Ostomy; Palliative care; Parenteral Nutrition - methods; Pathogenesis; Pneumonia; Pneumonia, Bacterial - microbiology; Pneumonia, Bacterial - prevention & control; Prospective Studies; Respiration, Artificial - adverse effects; Sorbic Acid - administration & dosage; Sorbic Acid - adverse effects; Sorbic Acid - therapeutic use; Stomach - drug effects; Stomach - microbiology; Ventilation; Ventilators; Weaning
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2005.03.002

Tube feeding might increase gastric burden of pathogenic bacteria and predispose patients to ventilator-associated pneumonia. We sought to determine whether a tube feeding formula acidified using potassium sorbate could reduce gastric burden of potentially pathogenic bacteria. Prospective, randomized, double-blind trial. RML Specialty Hospital, a facility with expertise in weaning patients from prolonged mechanical ventilation. Thirty patients recovering from prolonged mechanical ventilation. Patients were randomized to receive either a standard tube feeding formula (n = 14) or a formula acidified using potassium sorbate to a pH of 4.25 (n = 16). Weekly quantitative cultures of gastric aspirates. The number of colony-forming units (CFUs) per patient was higher in the control than in the treatment group (53% ± 11% vs 9% ± 3.4%, threshold of ≥100 000 CFU/mL fluid, P = .003). The number of organisms isolated in each patient per week was higher among patients receiving standard tube feeding formula than among patients receiving acidified formula (0.91 ± 0.20 vs 0.13 ± 0.05 organisms per patient per week, threshold of ≥100 000 CFU/mL fluid, P = .0014). There was no difference in the incidence of gastrointestinal bleeding or ventilator-associated pneumonia between study groups. Tube feeding formula acidified using potassium sorbate was well tolerated and reduced gastric bacterial burden in patients recovering from prolonged mechanical ventilation.