Comparison of Different Early Enteral Feeding Formulas on Critically Ill Patients

Bukhari, Agussalim; Taslim, Nurpudji Astuti; As’ad, Suryani; Rasyid, Haerani; Aminuddin, Aminuddin; Muchtar, Faisal; R, Rosdiana; Umrayani,; Rusli, Christina

doi:10.3177/jnsv.66.s2

Cited by 9 publications

(8 citation statements)

References 25 publications

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“…In one included study, only 2 out of the 3 groups randomized with similarities in energy and differences in protein dose were included in our meta-analysis [19]. This study also reported the nutritional delivery and LOS outcomes separately for traumatic brain injury (TBI) and non-TBI group, and these were pooled into a single mean and SD [18].…”

Section: Data Collection Process and Data Itemsmentioning

confidence: 99%

“…Nineteen RCTs totaling 1731 patients were included (sample size range: 14-474) [14,15,19,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]. Study characteristics are summarized in Table 2.…”

Section: Studies and Patients Characteristicsmentioning

confidence: 99%

“…Seven studies were conducted in Europe [15,25,27,30,33,35,37], four in Australia [24,26,32,39], four in Asia [14,19,28,36], two in North America [31,34], two in South America [29,38]. Nine studies included mixed medical and surgical population [14, 24-27, 29, 30, 32, 39], four included patients with stroke or head injury [31,33,34,36], one included only medical [38], one included only surgical patients [15], and population studied (medical/surgical) was unclear in four studies [19,28,35,37]. One study included only overweight (BMI ≥ 25) [27], one included only obese (BMI ≥ 30) patients [35], and one included patients with non-oliguric acute renal failure requiring PN [37].…”

Section: Studies and Patients Characteristicsmentioning

confidence: 99%

“…The duration of intervention ranged 3 to 28 days. Sixteen studies used an EN delivery strategy and 9 of them achieved higher protein by using an EN formula with higher protein content [19,25,27,30,[32][33][34][35][36]. Other patients' baseline and nutritional characteristics can be found in Additional file 2: Tables S4 and S5.…”

Section: Studies and Patients Characteristicsmentioning

confidence: 99%

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The effect of higher versus lower protein delivery in critically ill patients: a systematic review and meta-analysis of randomized controlled trials

et al. 2021

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Background The optimal protein dose in critical illness is unknown. We aim to conduct a systematic review of randomized controlled trials (RCTs) to compare the effect of higher versus lower protein delivery (with similar energy delivery between groups) on clinical and patient-centered outcomes in critically ill patients. Methods We searched MEDLINE, EMBASE, CENTRAL and CINAHL from database inception through April 1, 2021.We included RCTs of (1) adult (age ≥ 18) critically ill patients that (2) compared higher vs lower protein with (3) similar energy intake between groups, and (4) reported clinical and/or patient-centered outcomes. We excluded studies on immunonutrition. Two authors screened and conducted quality assessment independently and in duplicate. Random-effect meta-analyses were conducted to estimate the pooled risk ratio (dichotomized outcomes) or mean difference (continuous outcomes). Results Nineteen RCTs were included (n = 1731). Sixteen studies used primarily the enteral route to deliver protein. Intervention was started within 72 h of ICU admission in sixteen studies. The intervention lasted between 3 and 28 days. In 11 studies that reported weight-based nutrition delivery, the pooled mean protein and energy received in higher and lower protein groups were 1.31 ± 0.48 vs 0.90 ± 0.30 g/kg and 19.9 ± 6.9 versus 20.1 ± 7.1 kcal/kg, respectively. Higher vs lower protein did not significantly affect overall mortality [risk ratio 0.91, 95% confidence interval (CI) 0.75–1.10, p = 0.34] or other clinical or patient-centered outcomes. In 5 small studies, higher protein significantly attenuated muscle loss (MD −3.44% per week, 95% CI −4.99 to −1.90; p < 0.0001). Conclusion In critically ill patients, a higher daily protein delivery was not associated with any improvement in clinical or patient-centered outcomes. Larger, and more definitive RCTs are needed to confirm the effect of muscle loss attenuation associated with higher protein delivery. PROSPERO registration number: CRD42021237530

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Section: Data Collection Process and Data Itemsmentioning

confidence: 99%

Section: Studies and Patients Characteristicsmentioning

confidence: 99%

Section: Studies and Patients Characteristicsmentioning

confidence: 99%

Section: Studies and Patients Characteristicsmentioning

confidence: 99%

See 2 more Smart Citations

The effect of higher versus lower protein delivery in critically ill patients: a systematic review and meta-analysis of randomized controlled trials

et al. 2021

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“…In the past two decades, with increasing understanding of the therapeutic role and signi cance of EN for critically ill patients, experts and researchers have conducted a series of explorations on how to improve gastrointestinal dysfunctions and reduce the incidence of feeding intolerance in STBI patients [9][10][11]. A variety of preventive and curative strategies for feeding intolerance have now been applied in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Preventive Strategies for Feeding Intolerance in Patients with Severe Traumatic Brain Injury in China: An Online Cross-Sectional Survey

Fang

et al. 2021

Preprint

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Background The application of preventive strategies for feeding intolerance in severe traumatic brain injury (STBI) patients is discrepant among different hospitals. We aim to investigate the application status of preventive measures of feeding intolerance in China. Method A cross-sectional study was carried out among 996 clinicians and nurses working in intensive care units of 89 hospitals in China (response rate of 89.81%). Data were collected by means of an online survey. Descriptive statistics were used to analyze respondents’ characteristics and questionnaire responses. Results Clinicians and nurses usually applied several methods simultaneously to assess gastrointestinal functions and risk of feeding intolerance among STBI patients, including assessment scales, gastrointestinal symptoms, etc. Furthermore, initiating enteral nutrition (EN) within 24-48 hours (61.45%), < 500 ml initial volume of EN solution (50.00%), using non-nutritional preparations as initial EN formula (65.56%), nasogastric tube EN (91.16%), continuous feeding by pump (72.89%), 30°-45° of head-of-bed elevation during EN (89.46%), monitoring gastric residual volume by syringe (93.67%), assessing gastric residual volume every 4 hours (51.51%), EN solution temperature of 38℃-40℃ (65.46%), prokinetic agents (73.29%), enema (73.59%), probiotics (79.01%), and antacid agents (84.13%), were mostly applied strategies in clinical practice for preventing feeding intolerance among STBI patients. Conclusions The data from the survey showed that medical staffs in China are closely concerned with the gastrointestinal functions of STBI patients and EN delivery protocol, and have a positive attitude towards preventive strategies for feeding intolerance. Meanwhile, there are still many points need to be paid attention to and solved, and researchers, clinicians, nurses and dietitians should strengthen the cooperation to explore more valuable preventive strategies for feeding intolerance in STBI patients.

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Isolation and characterization of novel cadmium-resistant Escherichia fergusonii ZSF-15 from industrial effluent for flocculant production and antioxidant enzyme activity

Zafar,

Ashraf,

Hayat

et al. 2024

Environ Monit Assess

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Comparison of Different Early Enteral Feeding Formulas on Critically Ill Patients

Cited by 9 publications

References 25 publications

The effect of higher versus lower protein delivery in critically ill patients: a systematic review and meta-analysis of randomized controlled trials

The effect of higher versus lower protein delivery in critically ill patients: a systematic review and meta-analysis of randomized controlled trials

Preventive Strategies for Feeding Intolerance in Patients with Severe Traumatic Brain Injury in China: An Online Cross-Sectional Survey

Isolation and characterization of novel cadmium-resistant Escherichia fergusonii ZSF-15 from industrial effluent for flocculant production and antioxidant enzyme activity

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