Abstract PR121

Background & Objectives: Fibre (including prebiotics) supplementation in enteral formula reduces diarrhoea incidence in non-critically ill patients receiving enteral nutrition (EN). Prebiotics will be fermented to short chain fatty acid (SCFA) and stimulate the growth of bifidobacteria which helps in minimising diarrhoea. The obejectives of this study are to evaluate the incidence of diarrhoea and faecal microbiota concentrations (total bacteria, bifidobacteria, lactobacilli, bacteroides, clostridia and Faecalibacterium prausnitzii) between critically ill patients who receive enteral formula with and without fibre/prebiotics during EN. Materials & Methods: Adult patients in the intensive care unit who were starting EN were randomly allocated to receive either a fibre-free (FF) formula or fibre/prebiotic-supplemented enteral formula (10g/L FOS) for up to 14 days. Nutritional delivery and faecal output were recorded daily. Fresh faecal samples were collected at baseline, 1 week and 2 weeks. Faecal output was recorded using King’s stool chart and faecal microbiotas were analysed using real-time polymerase chain reaction. Results: At the end of the intervention (N=15), patients in the fibre/prebiotics group had a trend of lower stool frequency (1.2±0.6) compared to patients receiving the fibre-free enteral formula (1.8±0.9), p=0.092. However, there was no difference in incidence of diarrhoea between the groups. There were no significant differences in the concentrations of bifidobacteria between the groups (fibre/prebiotics 8.2±1.9 vs. FF 5.7±2.7 log10 copy number/g faeces, p= 0.07) but there were significantly lower concentrations of F. prausnitzii (4.5±2.0 vs. 6.9±1.7 log10 copy number/g faeces, p=0.03) in patients receiving fibre/prebiotics. Conclusion: Provision of prebiotics as the sole source of fibre in EN may not increase faecal bifidobacteria concentrations of critically ill patients. However, the provision of prebiotics may be useful in alleviating diarrhoea by reducing the stool frequency. Disclosure of Interest: M. Kamarul Zaman Research grant/funding from: University of Malaya Research Grant (No. PG127-2013A), V. Rai: None declared, M. S. Hasan: None declared, H. Abdul Majid: None declared