Department of Critical Care Medicine, The First Hospital of Jilin University, Chaoyang District, Changchun City, 130021, Jilin Province, China.
Sci Rep. 2023 Nov 22;13(1):20469. doi: 10.1038/s41598-023-47422-z.
Small peptide formulas versus standard polymeric formulas for enteral nutrition in critically ill patients with acute gastrointestinal injury (AGI) have been a topic of debate. A systematic review and meta-analysis were conducted to compare their clinical and nutritional outcomes. Relevant studies from January 1980 to June 2022 were searched in PubMed, Cochrane, and Embase databases. Randomized controlled trials involving AGI grade I-IV patients were included, while children, non-AGI patients, and non-critically ill patients were excluded. Results indicated no significant difference in all-cause mortality. Patients receiving small peptide formulas showed higher daily protein intake, greater albumin growth, and higher prealbumin levels. They also had shorter lengths of stay in the intensive care unit and hospital. Conversely, patients receiving standard polymeric formulas had a higher daily calorie intake. In conclusion, the choice of formula may not affect mortality in critically ill patients with AGI. Small peptide formulas were more conducive to increase daily protein intake, decrease intensive care unit and hospital length of stay. Further large-scale randomized controlled trials evaluating the effects of these two nutritional formulas on clinical and nutritional outcomes in critically ill patients with AGI are needed to confirm these results.
在急性胃肠损伤（AGI）的危重症患者中，肠内营养的小分子肽配方与标准聚合体配方一直是争论的话题。本研究旨在进行系统评价和荟萃分析，比较它们的临床和营养结局。从 1980 年 1 月到 2022 年 6 月，在 PubMed、Cochrane 和 Embase 数据库中检索相关研究。纳入 AGI 分级 I-IV 患者的随机对照试验，排除儿童、非 AGI 患者和非危重症患者。结果表明，全因死亡率无显著差异。接受小分子肽配方的患者每日蛋白质摄入量更高，白蛋白增长更大，前白蛋白水平更高。他们在重症监护病房和医院的住院时间也更短。相反，接受标准聚合体配方的患者每日热量摄入更高。总之，在 AGI 的危重症患者中，配方的选择可能不会影响死亡率。小分子肽配方更有利于增加每日蛋白质摄入量，缩短重症监护病房和医院的住院时间。需要进一步进行大规模的随机对照试验，评估这两种营养配方对 AGI 危重症患者的临床和营养结局的影响，以证实这些结果。
