ArticleCritical care (London, England)2011
Malabsorption and nutritional balance in the ICU: fecal weight as a biomarker: a prospective observational pilot study.
Article in Critical care (London, England), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 65 citations in OpenAlex.
- Measurement of Fecal Energy Loss Using Bomb Calorimetry in Adult Patient Populations: A Systematic Review and Meta-Analysis.Nutrients · 2026Pooled it
- Glycine by enteral route does not improve major clinical outcomes in severe COVID-19: a randomized clinical pilot trial.Scientific reports · 2024Trial
- Trial
- Effect of the route of nutrition and L-alanyl-L-glutamine supplementation in amino acids' concentration in trauma patients.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2018Trial
- Exocrine pancreatic insufficiency as an overlooked cause of chronic diarrhea after Billroth II gastrectomy identified through nutrition-focused assessment: a case report.Clinical nutrition research · 2026Article
- Time-course changes in energy expenditure in sepsis: a prospective observational study.Annals of intensive care · 2025Article
- Effects of managing fecal consistency on body weight in rats given liquid diets with pectin via tube feeding.BMC research notes · 2025Article
- The Japanese Critical Care Nutrition Guideline 2024.Journal of intensive care · 2025Review
- Intestinal Drug Absorption After Subarachnoid Hemorrhage and Elective Neurosurgery: Insights From Esomeprazole Pharmacokinetics.Critical care medicine · 2025Observational
- Dose-response relationship between diarrhea quantity and mortality in critical care patients: A retrospective cohort study.PloS one · 2023Article
- Nutritional intake and gastro-intestinal symptoms in critically ill COVID-19 patients.Clinical nutrition (Edinburgh, Scotland) · 2022Observational
- When is parenteral nutrition indicated?Journal of intensive medicine · 2022Review
- Gastrointestinal manifestations and possible mechanisms of COVID-19 in different periods.Journal of digestive diseases · 2021Review
- Understanding the physiology of human defaecation and disorders of continence and evacuation.Nature reviews. Gastroenterology & hepatology · 2021Review
- Energy expenditure and feeding practices and tolerance during the acute and late phase of critically ill COVID-19 patients.Clinical nutrition ESPEN · 2021Observational
- Acute Intestinal Failure.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2020Review
- Article
- Gastrointestinal dysfunction in the critically ill: a systematic scoping review and research agenda proposed by the Section of Metabolism, Endocrinology and Nutrition of the European Society of Intensive Care Medicine.Critical care (London, England) · 2020Article
- Quantification of diacylglycerol and triacylglycerol species in human fecal samples by flow injection Fourier transform mass spectrometry.Analytical and bioanalytical chemistry · 2020Article
- Enteral tolerance in critically ill patients.Journal of intensive care · 2019Review
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMalabsorption, which is frequently underdiagnosed in critically ill patients, is clinically relevant with regard to nutritional balance and nutritional management. We aimed to validate the diagnostic accuracy of fecal weight as a biomarker for fecal loss and additionally to assess fecal macronutrient contents and intestinal absorption capacity in ICU patients.
methodsThis was an observational pilot study in a tertiary mixed medical-surgical ICU in hemodynamically stable adult ICU patients, without clinically evident gastrointestinal malfunction. Fecal weight (grams/day), fecal energy (by bomb calorimetry in kcal/day), and macronutrient content (fat, protein, and carbohydrate in grams/day) were measured. Diagnostic accuracy expressed in terms of test sensitivity, specificity, positive (PPV) and negative predictive value (NPV), and receiver operator curves (ROCs) were calculated for fecal weight as a marker for energy malabsorption. Malabsorption was a priori defined as < 85% intestinal absorption capacity.
resultsForty-eight patients (63 ± 15 years; 58% men) receiving full enteral feeding were included. A cut-off fecal production of > 350 g/day (that is, diarrhea) was linked to the optimal ROC (0.879), showing a sensitivity and PPV of 80%, respectively. Specificity and NPV were both 96%. Fecal weight (grams/day) and intestinal energy-absorption capacity were inversely correlated (r = -0.69; P < 0.001). Patients with > 350 g feces/day had a significantly more-negative energy balance compared with patients with < 350 g feces/day (loss of 627 kcal/day versus neutral balance; P = 0.012).
conclusionsA fecal weight > 350 g/day in ICU patients is a biomarker applicable in daily practice, which can act as a surrogate for fecal energy loss and intestinal energy absorption. Daily measurement of fecal weight is a feasible means of monitoring the nutritional status of critically ill patients and, in those identified as having malabsorption, can monitor responses to changes in dietary management.
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