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危重症患者早期低热量肠内营养支持的效果:系统评价和荟萃分析。

Effect of Early Low-Calorie Enteral Nutrition Support in Critically Ill Patients: A Systematic Review and Meta-analysis.

机构信息

Department of Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China.

出版信息

Biomed Res Int. 2022 Jul 4;2022:7478373. doi: 10.1155/2022/7478373. eCollection 2022.

Abstract

OBJECTIVE

The purpose of this research was to rigorously assess the impact of early low-fever enteral feeding supplementation in critically sick patients.

METHODS

PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and Physiotherapy Evidence Database were searched for randomized controlled trials related to enteral nutrition support of critically ill patients (retrieval time was limited to June 30, 2021); data were extracted after screening the literature, and the quality of meta-analysis was evaluated.

RESULTS

When compared to adequate caloric enteral nutrition support, early low caloric enteral nutrition support reduces the incidence of intolerance to nutrition support (MD = 0.60, 95 percent CI: -0.18 to 1.39, = 0.13) and the insulin dose during enteral nutrition support (MD = -17.21, 95 percent CI: -19.91 to -14.51, = 0.00001). However, it had no effect on intensive care unit (ICU) treatment duration (MD = 0.60, 95 percent CI: -0.18 to 1.39, = 0.13), in-hospital mortality (MD = 0.60, 95 percent CI: -0.18 to 1.39, = 0.13), or infection incidence (OR = 1.00, 95 percent CI: 0.85, 1.19, = 0.98).

CONCLUSION

When compared to sufficient caloric enteral nutrition support, early low-calorie enteral nutrition support lowers the risk of severe illness. The rate of intolerance to nutritional assistance and the decrease in insulin dosage supplied had no effect on the length of ICU therapy, patient death, or infection incidence.

摘要

目的

本研究旨在严格评估早期低热肠内喂养补充对危重症患者的影响。

方法

检索 PubMed、Embase、Web of Science、Cochrane 对照试验中心注册库、护理学及相关健康专业文献累积索引和物理治疗证据数据库,检索与危重病患者肠内营养支持相关的随机对照试验(检索时间截至 2021 年 6 月 30 日);筛选文献后提取数据,并评价荟萃分析质量。

结果

与充足的热量肠内营养支持相比,早期低热卡肠内营养支持可降低不耐受营养支持的发生率(MD = 0.60,95%CI:-0.18 至 1.39, = 0.13)和肠内营养支持期间的胰岛素剂量(MD = -17.21,95%CI:-19.91 至-14.51, = 0.00001)。然而,它对重症监护病房(ICU)治疗时间(MD = 0.60,95%CI:-0.18 至 1.39, = 0.13)、院内死亡率(MD = 0.60,95%CI:-0.18 至 1.39, = 0.13)或感染发生率(OR = 1.00,95%CI:0.85,1.19, = 0.98)均无影响。

结论

与充足的热量肠内营养支持相比,早期低热卡肠内营养支持可降低严重疾病的风险。不耐受营养支持的发生率和胰岛素剂量的降低对 ICU 治疗时间、患者死亡或感染发生率均无影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1013/9273443/ac50ce76bc13/BMRI2022-7478373.001.jpg

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