Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Level 3, 555 St Kilda Rd, Melbourne, VIC, 3004, Australia; Nutrition and Dietetics Department, Box Hill Hospital, Eastern Health, 8 Arnold Street, Box Hill, Melbourne, VIC, 3128, Australia.
Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Level 3, 555 St Kilda Rd, Melbourne, VIC, 3004, Australia.
Aust Crit Care. 2022 Sep;35(5):564-574. doi: 10.1016/j.aucc.2021.09.001. Epub 2021 Oct 27.
The primary objective was to compare the intake of important micronutrients provided from enteral nutrition to critically ill patients with the Australia and New Zealand recommended dietary intakes. A secondary objective was to compare the upper levels of intake and investigate prespecified subgroups.
A systematic literature review was performed.
MEDLINE, EMBASE, CINAHL, and CENTRAL were used.
Databases were searched for randomised controlled trials that investigated an enteral nutrition intervention as the sole source of nutrition, were published in English between January 2000 and January 8th, 2021, and provided data to calculate micronutrient intake. The primary outcome was the % recommended dietary intake. The quality of individual trials was assessed using the Cochrane Risk of Bias Tool. Outcomes are presented as either mean ± standard deviation or median [interquartile range], with a p < 0.05 considered statistically significant.
Thirteen trials were included (n = 1538 patients). Trials investigating hypocaloric nutrition were excluded from the primary outcome assessment (conducted in nine trials (n = 1220)). All nine trials delivered ≥104% of the recommended dietary intakes and <100% of the upper level of intakes of all micronutrients. In subgroup analyses, trials with ≥80% target energy delivered a higher % of the recommended dietary intake of vitamin B12, thiamine, zinc, and vitamin C. Acute Physiology and Chronic Health Evaluation scores ≥20 delivered a higher % of the recommended dietary intake of vitamin B12 and vitamin A. Antioxidant formulas compared with standard formulas delivered a higher % recommended dietary intake of vitamin C and thiamine. In the four trials that investigated hypocaloric feeding compared with control, there was no difference in micronutrient intake. The quality was low.
Enteral nutrition delivery frequently met the recommended dietary intakes for all micronutrients investigated and did not exceed the upper levels of intake set for health.
CRD42020178333.
主要目的是比较肠内营养为危重症患者提供的重要微量营养素摄入量与澳大利亚和新西兰推荐膳食摄入量。次要目的是比较摄入量上限，并调查预设亚组。
进行了系统的文献回顾。
使用 MEDLINE、EMBASE、CINAHL 和 CENTRAL 数据库。
检索了 2000 年 1 月至 2021 年 1 月 8 日期间以英文发表的、仅作为营养来源的肠内营养干预的随机对照试验，提供了计算微量营养素摄入量的数据。主要结果是推荐膳食摄入量的百分比。使用 Cochrane 偏倚风险工具评估个体试验的质量。结果以平均值 ±标准差或中位数[四分位间距]表示，p < 0.05 被认为具有统计学意义。
纳入了 13 项试验（n = 1538 名患者）。主要结局评估排除了低热量营养的试验（9 项试验（n = 1220 人））。所有 9 项试验均提供了≥104%的推荐膳食摄入量和<100%的所有微量营养素的摄入量上限。在亚组分析中，目标能量≥80%的试验提供了更高的维生素 B12、硫胺素、锌和维生素 C 的推荐膳食摄入量百分比。急性生理学和慢性健康评估评分≥20 的试验提供了更高的维生素 B12 和维生素 A 的推荐膳食摄入量百分比。与标准配方相比，抗氧化配方提供了更高的维生素 C 和硫胺素的推荐膳食摄入量百分比。在与对照组相比调查低热量喂养的四项试验中，微量营养素摄入量没有差异。质量较低。
肠内营养的提供经常满足所有研究微量营养素的推荐膳食摄入量，且未超过为健康设定的摄入量上限。
CRD42020178333。
