Najmeh Seifi - Department of Nutrition, Medical School, Mashhad University of Medical Sciences, Mashhad, Iran
Alireza Sedaghat - Department of Anesthesiology, Mashhad University of Medical Sciences, Mashhad, Iran
Majid Khademrezaiyan - Department of community medicine, Medical School, Mashhad University of Medical Sciences, Mashhad, Iran
Mohsen Nematy - Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Reza Rezvani - Department of Nutrition, Medical School, Mashhad University of Medical Sciences, Mashhad, Iran
Mohammad Safarian - Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Introduction: Dysbiosis in critically ill patients may make them prone to energy and macronutrients homeostasis disturbance. The aim of this study was to evaluate the effect of synbiotic supplementation on energy and protein homeostasis in critically ill patients.Methods: In this double-blind randomized controlled trial, critically ill adult patients who were starting enteral nutrition with hospital formula via nasogastric tube, were randomized to receive Lactocare (ZistTakhmir) or an identical placebo capsule two twice a day for a maximum of 14 days (20 subjects in each group). Daily, enteral feed volume, energy and protein intakes were recorded. 24-hour urine was collected to measure nitrogen balance before and after the intervention. Data were analyzed via SPSS statistical software. Statistical significance was set at p< 0.05.Results: Thirty-eight patients (mean age 42.82 years) completed at least four days of intervention (mean 10.29 days). At baseline, both groups were similar regarding age, disease severity and nutritional risk. In the synbiotic group enteral feed volume, energy and protein intake significantly increased in day 4 (962.5±533.82 ml, 770±427.05 Kcal and 38.5±21.35 gr, respectively) compared to day 1 (590±321.1 ml, 472±256.81 Kcal and 23.6±12.84 gr respectively, P value< 0.01). Although, there was no significant change in the control group comparing day 1 with 4. At the end of the intervention, no significant difference was found in total feed volume, energy and protein intake and nitrogen balance between two groups.Conclusion: Gut microbiota modulation through synbiotics has no statistically significant effect on energy and protein homeostasis.

critical care, energy, gut microbiota, synbiotics