- 期刊
Initial energy supplementation in critically ill patients receiving enteral nutrition: a systematic review and meta-analysis of randomized controlled trials
摘要
Background and Objectives: Here we systematically reviewed and quantitatively analyzed randomized controlled trials (RCTs) to compare the important initial outcomes of critically ill adults receiving low- and highenergy enteral nutrition. Methods and Study Design: 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 (CIs) were the effect measures. Results: Eleven RCTs (3,212 patients) were included. The groups did not differ significantly in mortality (RR, 0.94; 95% CI, 0.80-1.11; p=0.47), infections morbidity (RR 1.09; 95% CI 0.95-1.26; p=0.23), pneumonia morbidity (RR 1.04; 95% CI 0.88-1.23; p=0.68), hospital length of stay (WMD -0.27; 95% CI -3.21 to 3.76; p=0.88), intensive care unit length of stay (WMD -0.32; 95% CI, -1.81 to 1.16; p=0.46), mechanical ventilation days (WMD -0.30; 95% CI-1.42 to 0.82; p=0.60). The incidence of gastrointestinal intolerance was significantly lower in the low-energy group (RR 0.79; 95% CI 0.65-0.97; p＜0.05). Conclusions: The initial administration of low- versus high-energy supplements did not impact clinical outcomes except for gastrointestinal intolerance in non-malnourished critically ill patients receiving enteral nutrition. The initial administration of highrather 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
- Wan, X., Gao, X. J., Tian, F., Wu, C., & Wang, X. Y. (2013). Early Parenteral Nutrition Alone or Accompanying Enteral Nutrition in Criticallyill Patients: A Systematic Review and Meta-analysis. Asia Pacific Journal of Clinical Nutrition, (), 1-12. https://doi.org/10.6133/apjcn.2015.24.2.07
- Wan, X., Gao, X. J., Tian, F., Wu, C., & Wang, X. Y. (2015). Early Parenteral Nutrition Alone or Accompanying Enteral Nutrition in Critically Ill Patients: A Systematic Review and Meta-Analysis. Asia Pacific Journal of Clinical Nutrition, 24(2), 227-233. https://doi.org/10.6133/apjcn.2015.24.2.07
- Kim, S. H., Park, C. M., Seo, J. M., Choi, M., Lee, D. S., Chang, D. K., Rha, M., Yu, S. Y., Lee, S. H., Kim, E., & Cho, Y. Y. (2013). The Impact of Implementation of an Enteral Feeding Protocol on the Improvement of Enteral Nutrition in Critically Ill Adults. Asia Pacific Journal of Clinical Nutrition, (), 1-17. https://doi.org/10.6133/apjcn.122015.01
- Kim, S. H., Park, C. M., Seo, J. M., Choi, M., Lee, D. S., Chang, D. K., Miyong, Yu, S., Lee, S., Kim, E., & Cho, Y. (2017). The impact of implementation of an enteral feeding protocol on the improvement of enteral nutrition in critically ill adults. Asia Pacific Journal of Clinical Nutrition, 26(1), 27-35. https://doi.org/10.6133/apjcn.122015.01
- Xi, F. C., Xu, X. W., Tan, S. J., Gao, T., Shi, J. L., Kong, Y. X., Yu, W. K., Li, J. S., & Li, N. (2013). Efficacy and safety of pectin-supplemented enteral nutrition in intensive care unit patients: a randomized controlled trial. Asia Pacific Journal of Clinical Nutrition, (), 1-14. https://doi.org/10.6133/apjcn.082016.07