Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Oct 27, 2016; 8(10): 700-705
Published online Oct 27, 2016. doi: 10.4240/wjgs.v8.i10.700
Peptide-based enteral formula improves tolerance and clinical outcomes in abdominal surgery patients relative to a whole protein enteral formula
Ming-Yi Liu, Hsiu-Chih Tang, Shu-Hui Hu, Sue-Joan Chang
Ming-Yi Liu, Department of Nutrition, Tainan Sin-Lau Hospital, Tainan City 70142, Taiwan
Hsiu-Chih Tang, Department of Surgery, Tainan Sin-Lau Hospital, Tainan City 70142, Taiwan
Shu-Hui Hu, Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung 807, Taiwan
Shu-Hui Hu, Department of Nutrition and Dietetics, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
Ming-Yi Liu, Sue-Joan Chang, Department of Life Sciences, College of Bioscience and Biotechnology, National Cheng Kung University, Tainan City 701, Taiwan
Author contributions: Liu MY and Hu SH carried out the studies and data analyses; Liu MY drafted the manuscript; Chang SJ supervised the procedure, provided significant advice and revised the manuscript; Tang HC developed the protocol, cared the patients, provided advice and revised the manuscript; Hu SH collected the data and provided nutrition care; all of the authors have read and approved the final manuscript; Liu MY and Hu SH contributed equally to this work.
Institutional review board statement: The study was eligible for a determination of “exempt review” status by the ethics committee of the Tainan Sin-Lau Hospital (Grant No. SLH919-02).
Informed consent statement: A retrospective study was deployed to investigate the effects of a dipeptide- and tripeptide-based enteral formula. Patients were screened from the ICU database, therefore we did not seek informed consent. Acquisition of patient data and its subsequent use were approved by the ethics committee of the Tainan Sin-Lau Hospital (Grant No. SLH919-02). Patient information was anonymized and de-identified prior to analysis.
Conflict-of-interest statement: No conflicts of interest to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Sue-Joan Chang, Department of Life Sciences, College of Bioscience and Biotechnology, National Cheng Kung University, No.1, University Rd., Tainan City 701, Taiwan. sjchang@mail.ncku.edu.tw
Telephone: +886-6-2757575 Fax: +886-6-2742583
Received: April 9, 2016
Peer-review started: April 10, 2016
First decision: June 6, 2016
Revised: June 19, 2016
Accepted: August 6, 2016
Article in press: August 8, 2016
Published online: October 27, 2016
Abstract
AIM

To compare a dipeptide- and tripeptide-based enteral formula with a standard enteral formula for tolerance and nutritional outcomes in abdominal surgery patients.

METHODS

A retrospective study was performed to assess the differences between a whole-protein formula (WPF) and a dipeptide- and tripeptide-based formula (PEF) in clinical outcomes. Seventy-two adult intensive care unit (ICU) patients with serum albumin concentrations less than 3.0 g/dL were enrolled in this study. Patients were divided into two groups (WPF group = 40 patients, PEF group = 32 patients). The study patients were fed for at least 7 d, with ≥ 1000 mL of enteral formula infused on at least 3 of the days.

RESULTS

The mean serum albumin level on postoperative day (POD) 10, prealbumin levels on POD-5 and POD-10, and total lymphocyte count on POD-5 were significantly higher in the PEF group compared to those in the WPF group (P < 0.05). The average maximum gastric residual volume of the PEF patients during their ICU stays was significantly lower than that for WPF patients.

CONCLUSION

Dipeptide- and tripeptide-based enteral formulas are more efficacious and better tolerated than whole-protein formulas.

Keywords: Dipeptides and tripeptides, Enteral nutrition, Abdominal surgery, Gastric residual volume, Absorption

Core tip: Few trials thus far have investigated the benefits of dipeptide- and tripeptide-based enteral formulas for abdominal surgery patients. The results of the present study suggest that dipeptide- and tripeptide-based enteral formulas are more efficacious and better tolerated than whole-protein formulas and could shorten the intensive care unit stays of malnourished abdominal surgery patients.