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Feng L, Xiang D, Wu Y. Clinical effects and safety of semi-solid feeds in tube-fed patients: a meta-analysis and systematic review. Front Nutr 2024; 11:1331904. [PMID: 38725574 PMCID: PMC11079128 DOI: 10.3389/fnut.2024.1331904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/20/2024] [Indexed: 05/12/2024] Open
Abstract
Background Enteral nutrition is a very important form of treatment for critically ill patients. This meta-analysis aimed to evaluate the clinical effects and safety of semi-solid feeds in tube-fed patients. Methods Two researchers searched PubMed, clinical trials, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Weipu databases for randomized controlled trials (RCTs) on the clinical effects and safety of semi-solid feeds in tube-fed patients until 10 October 2023. The quality evaluation tool recommended by the Cochrane Library was used to evaluate the quality of included RCTs. RevMan 5.4 software was used for data analysis. Results A total of eight RCTs involving 823 tube-fed patients were included in this meta-analysis. A synthesized outcome indicated that semi-solid feeds reduced the incidence of diarrhea (RR = 0.32, 95%CI:0.20-0.50, P < 0.001), vomiting (RR = 0.31, 95%CI:0.15-0.64, P = 0.002), abdominal distension (RR = 0.41, 95%CI:0.22-0.76, P = 0.005), length of intensive care unit (ICU) stay (MD = -3.61, 95%CI: -6.74 to -0.48, P = 0.02), and length of hospital stay (MD = -7.14, 95%CI: -10.31 to -3.97, P < 0.01) in tube-fed patients. Enteric feeding had no effect on the 30-day mortality (RR = 0.55, 95%CI: 0.19-1.56, P = 0.26). No publication bias was detected by the Egger's test results (all P > 0.05). Conclusion Semi-solid feeds are beneficial in reducing the incidence of diarrhea, abdominal distension, vomiting, and hospital stay. More high-quality studies are needed in the future to verify the effects of semi-solid feeds on mortality.
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Affiliation(s)
- Limei Feng
- Department of Neurosurgery, Wuxi No. 5 Affiliated Hospital of Jiangnan University, Wuxi No. 5 People's Hospital, Wuxi, Jiangsu, China
| | - Dingchao Xiang
- Department of Neurosurgery, Wuxi No. 5 Affiliated Hospital of Jiangnan University, Wuxi No. 5 People's Hospital, Wuxi, Jiangsu, China
| | - Youping Wu
- Department of Neurosurgical Intensive Care Unit, Wuxi Taihu Hospital, Wuxi Clinical College of Anhui Medical University, Wuxi, Jiangsu, China
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Zhong M, Qiu Y, Pan T, Wang R, Gao Y, Wang X, Li Y, Lin Z, Wu Z, Tang J, Li X, Wang X, Zhang J, Feng G, Wang S, Lu X, Gong Y, Qu H, Chen E. Improving enteral nutrition tolerance and protein intake maybe beneficial to intensive care unit patients. Sci Rep 2023; 13:21614. [PMID: 38062232 PMCID: PMC10703788 DOI: 10.1038/s41598-023-49050-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023] Open
Abstract
Enteral nutrition (EN) is important for critically ill patients. This study investigated the current situation of EN treatment in SHANGHAI intensive care units (ICUs). We hypothesized that improving EN practice in SHANGHAI may benefit the prognosis of ICU patients. Clinical information on EN use was collected using clinic information forms in 2019. The collected data included the patient's general clinical information, EN prescription status, EN tolerance status, and clinical outcomes. The observation time points were days 1, 3, and 7 after starting EN. A total of 491 patients were included. The proportion of EN intolerance (defined as < 20 kcal/kg/day) decreased, with rates of intolerance of 100%, 82.07%, 70.61%, and 52.23% at 1, 3, 7, and 14 days, respectively. Age, mNutric score, and protein intake < 0.5 g/kg/day on day 7 were risk factors for 28-day mortality.The EN tolerance on day 7 and protein intake > 0.5 g/kg/day on day 3 or day 7 might affect the 28-day mortality. Risk factors with EN tolerance on day 7 by logistic regression showed that the AGI grade on day 1 was a major factor against EN tolerance. The proportion of EN tolerance in SHANGHAI ICU patients was low. Achieving tolerance on day 7 after the start of EN is a protective factor for 28-day survival. Improving EN tolerance and protein intake maybe beneficial for ICU patients.
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Affiliation(s)
- Ming Zhong
- Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuzhen Qiu
- Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tingting Pan
- Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruilan Wang
- Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuan Gao
- Department of Emergency and Critical Care Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuebin Wang
- Department of Critical Care Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yingchuan Li
- Department of Emergency and Critical Care Medicine, The Sixth People's Hospital of Shanghai, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhaofen Lin
- Department of Emergency and Critical Care Medicine, Shanghai Changzhen Hospital, Shanghai, China
| | - Zhixiong Wu
- Department of Emergency and Critical Care Medicine, Huadong Hospital, Shanghai, China
| | - Jianguo Tang
- Department of Emergency and Critical Care Medicine, The Fifth People's Hospital of Shanghai, Shanghai, China
| | - Xiang Li
- Department of Emergency and Critical Care Medicine, Central Hospital of Minghang District, Shanghai, China
| | - Xuemin Wang
- Department of Emergency and Critical Care Medicine, Central Hospital of Songjiang District, Shanghai, China
| | - Jiayu Zhang
- Department of Emergency and Critical Care Medicine, Central Hospital of Putuo District, Shanghai, China
| | - Gang Feng
- Department of Emergency and Critical Care Medicine, Gongli Hospital of Pudong New Area, Shanghai, China
| | - Sheng Wang
- Department of Emergency and Critical Care Medicine, The Tenth People's Hospital of Shanghai, Shanghai, China
| | - Xinyuan Lu
- Department of Emergency and Critical Care Medicine, Shanghai Pudong New Area People's Hospital, Shanghai, China
| | - Ye Gong
- Department of Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Hongping Qu
- Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Quality Improving Center of Critical Care Medicine, Shanghai, China
| | - Erzhen Chen
- Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai Quality Improving Center of Critical Care Medicine, Shanghai, China.
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