Permejo Chito C, Evangelista Teresita Joy Ples
Department of Physiology, College of Medicine, University of the Philippines, Manila, Ermita, Philippines.
Indian J Crit Care Med. 2024 Nov;28(11):1069-1083. doi: 10.5005/jp-journals-10071-24831. Epub 2024 Oct 30.
To examine the effect of hypocaloric/hyperproteic enteral feeding vs normocaloric feeding on the survival of critically ill patients in the acute phase in the intensive care unit (ICU).
Randomized clinical trials utilizing hypocaloric, hyperproteic, and normocaloric enteral feeding in the ICU were searched using the following terms ((((critically ill) OR (intensive care) OR (mechanically ventilated)) AND ((low-calorie enteral feeding) OR (high-protein enteral feeding)))) in MEDLINE, PubMed, Scopus, and Google Scholar by two independent authors.
There were no significant differences in hospital mortality [odds ratio (OR), 1.0; 95% confidence interval (CI), 0.77, 1.31; = 0.99, = 0%], days on mechanical ventilation (MD, -0.05; 95% CI, -0.37, 0.28; = 0.78, = 0%), the odds of acquiring infectious complications (OR, 0.90; 95% CI, 0.71, 1.14; = 0.38, = 0%), and the length of ICU stay (MD, 0.60; 95% CI, -2.39, 3.59; = 0.69, = 96%). The length of hospital stay was significantly lower by 4.18 days in the normocaloric group (MD, 4.18; 95% CI, 2.50, 5.85; < 0.00001, = 0%).
This meta-analysis showed no significant differences in mortality, infectious complications, days of mechanical ventilation, and ICU length of stay between groups. Findings on hospital length of stay were interpreted with caution due to the low quality of evidence and clinical heterogeneity.
Permejo CC, Evangelista TJP. Clinical Outcomes of Hypocaloric/Hyperproteic vs Normocaloric Enteral Feeding in the Acute Phase of Critical Illness among Patients Admitted in the Intensive Care Unit: A Systematic Review with Meta-analysis. Indian J Crit Care Med 2024;28(11):1069-1083.
探讨低热量/高蛋白肠内营养与正常热量肠内营养对重症监护病房（ICU）急性期重症患者生存的影响。
两名独立作者通过在MEDLINE、PubMed、Scopus和谷歌学术搜索中使用以下检索词（(((重症) 或 (重症监护) 或 (机械通气)) 且 ((低热量肠内营养) 或 (高蛋白肠内营养)))) 检索在ICU中使用低热量、高蛋白和正常热量肠内营养的随机临床试验。
在医院死亡率 [比值比 (OR)，1.0；95% 置信区间 (CI)，0.77，1.31；P = 0.99，I² = 0%]、机械通气天数 (MD，-0.05；95% CI，-0.37，0.28；P = 0.78，I² = 0%)、发生感染并发症的几率 (OR，0.90；95% CI，0.71，1.14；P = 0.38，I² = 0%) 以及ICU住院时间 (MD，0.60；95% CI，-2.39，3.59；P = 0.69，I² = 96%) 方面无显著差异。正常热量组的住院时间显著缩短4.18天 (MD，4.18；95% CI，2.50，5.85；P < 0.00001，I² = 0%)。
该荟萃分析表明，两组之间在死亡率、感染并发症、机械通气天数和ICU住院时间方面无显著差异。由于证据质量低和临床异质性，对住院时间的研究结果应谨慎解读。
Permejo CC, Evangelista TJP. Clinical Outcomes of Hypocaloric/Hyperproteic vs Normocaloric Enteral Feeding in the Acute Phase of Critical Illness among Patients Admitted in the Intensive Care Unit: A Systematic Review with Meta-analysis. Indian J Crit Care Med 2024;28(11):1069-1083.
