- 期刊
- Ahead-of-Print
Initial Energy Supplementationin Critically Ill Patients Receiving Enteral Nutrition: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
並列摘要
Introduction: Here we systematically reviewed and quantitatively analyzed randomized controlled trials (RCTs) to compare the important initial outcomes of critically ill adults receiving low- and high-energy enteral nutrition. Methods: RCTs comparing low- and high-energy supplementation in critically ill adults receiving enteral nutrition admitted to the intensive care unit for an expected stay of ＞48 h were included. Abstracts submitted to major scientific meetings were included and the primary endpoint was mortality. The risk ratio (RR) and weighted mean difference (WMD) with 95% confidence intervals (CI) were the effect measures. Results: Eight RCTs (2125 patients) were included. The groups did not differ significantly in mortality (RR, 0.94; 95% CI, 0.75-1.17; p=0.58), pneumonia morbidity (RR, 1.05; 95% CI, 0.83-1.34; p=0.68), hospital length of stay (WMD, -0.19; 95% CI, -3.87-3.50; p=0.92), intensive care unit length of stay (WMD, -0.58; 95% CI, -2.12-0.96; p=0.46), mechanical ventilation days (WMD, -0.30; 95% CI, -1.42-0.82; p=0.60), or gastrointestinal intolerance (RR, 0.73; 95% CI, 0.47-1.16; p=0.18). The incidence of infections was significantly lower in the high-energy group (RR, 1.19; 95% CI, 1.01- 1.42; p＜0.05). Conclusions: The initial administration of low- versus high-energy supplements did not impact clinical outcomes except for infections in non-malnourished critically ill patients receiving enteral nutrition. The initial administration of high-rather than low-energy may benefit these patients by reducing infections, but this effect might actually be attributable to the concomitant high protein intake.
延伸閱讀
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