Enteral nutrition and congestive heart failure: a systematic review

Abstract

Introduction: Congestive heart failure (CHF) is a serious and growing public health problem worldwide. Approximately 23 million people are carriers of this disease and two million new cases are diagnosed each year. The clinical evolution of patients with CHF is moving towards variable malnutrition, making it necessary to adhere to enteral nutrition (EN). This picture can occur due to inadequate intake, altered metabolism, proinflammatory state, increased oxidative stress, and greater loss of nutrients, even due to drug interactions. Objective: It was to carry out a systematic review of the main clinical outcomes that demonstrate the importance of enteral nutrition in patients with congestive heart failure. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from September to October 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 122 articles were found. A total of 87 articles were evaluated and 28 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 7 studies with a high risk of bias and 8 studies that did not meet GRADE. There is moderate scientific evidence of the effectiveness of enteral nutrition in increasing survival and reducing morbidity in patients with congestive heart failure, as there are few randomized clinical trials that have evaluated this issue, however, enteral nutrition is highly indicated in the attempt to mitigate weight loss in these patients.