Effect of Supplemental Parenteral Nutrition Versus Enteral Nutrition Alone on Clinical Outcomes in Critically Ill Adult Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Enteral nutrition (EN) is considered the first feeding route for critically ill patients. However, adverse effects such as gastrointestinal complications limit its optimal provision, leading to inadequate energy and protein intake. We compared the clinical outcomes of supplemental parenteral nutriti...
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| Format: | Article |
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MDPI AG
2020-09-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/12/10/2968 |
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| author | Dalal J. Alsharif Farah J. Alsharif Ghadeer S. Aljuraiban Mahmoud M. A. Abulmeaty |
| author_facet | Dalal J. Alsharif Farah J. Alsharif Ghadeer S. Aljuraiban Mahmoud M. A. Abulmeaty |
| author_sort | Dalal J. Alsharif |
| collection | DOAJ |
| description | Enteral nutrition (EN) is considered the first feeding route for critically ill patients. However, adverse effects such as gastrointestinal complications limit its optimal provision, leading to inadequate energy and protein intake. We compared the clinical outcomes of supplemental parenteral nutrition added to EN (SPN + EN) and EN alone in critically ill adults. Electronic databases restricted to full-text randomized controlled trials available in the English language and published from January 1990 to January 2019 were searched. The risk of bias was evaluated using the Jadad scale, and the meta-analysis was conducted using the MedCalc software. A total of five studies were eligible for inclusion in the systematic review and meta-analysis. Compared to EN alone, SPN + EN decreased the risk of nosocomial infections (relative risk (RR) = 0.733, <i>p</i> = 0.032) and intensive care unit (ICU) mortality (RR = 0.569, <i>p</i> = 0.030). No significant differences were observed between SPN + EN and EN in the length of hospital stay, hospital mortality, length of ICU stay, and duration of mechanical ventilation. In conclusion, when enteral feeding fails to fulfill the energy requirements in critically ill adult patients, SPN may be beneficial as it helps in decreasing nosocomial infections and ICU mortality, in addition to increasing energy and protein intakes with no negative effects on other clinical outcomes. |
| first_indexed | 2024-03-10T15:59:06Z |
| format | Article |
| id | doaj.art-b2f0d3d1d2c04c3e9568855d6bfb9046 |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-10T15:59:06Z |
| publishDate | 2020-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-b2f0d3d1d2c04c3e9568855d6bfb90462023-11-20T15:25:48ZengMDPI AGNutrients2072-66432020-09-011210296810.3390/nu12102968Effect of Supplemental Parenteral Nutrition Versus Enteral Nutrition Alone on Clinical Outcomes in Critically Ill Adult Patients: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsDalal J. Alsharif0Farah J. Alsharif1Ghadeer S. Aljuraiban2Mahmoud M. A. Abulmeaty3Department of Community Health Sciences, Clinical Nutrition Program, King Saud University, Riyadh 11362, Saudi ArabiaDepartment of Community Health Sciences, Clinical Nutrition Program, King Saud University, Riyadh 11362, Saudi ArabiaDepartment of Community Health Sciences, Clinical Nutrition Program, King Saud University, Riyadh 11362, Saudi ArabiaDepartment of Community Health Sciences, Clinical Nutrition Program, King Saud University, Riyadh 11362, Saudi ArabiaEnteral nutrition (EN) is considered the first feeding route for critically ill patients. However, adverse effects such as gastrointestinal complications limit its optimal provision, leading to inadequate energy and protein intake. We compared the clinical outcomes of supplemental parenteral nutrition added to EN (SPN + EN) and EN alone in critically ill adults. Electronic databases restricted to full-text randomized controlled trials available in the English language and published from January 1990 to January 2019 were searched. The risk of bias was evaluated using the Jadad scale, and the meta-analysis was conducted using the MedCalc software. A total of five studies were eligible for inclusion in the systematic review and meta-analysis. Compared to EN alone, SPN + EN decreased the risk of nosocomial infections (relative risk (RR) = 0.733, <i>p</i> = 0.032) and intensive care unit (ICU) mortality (RR = 0.569, <i>p</i> = 0.030). No significant differences were observed between SPN + EN and EN in the length of hospital stay, hospital mortality, length of ICU stay, and duration of mechanical ventilation. In conclusion, when enteral feeding fails to fulfill the energy requirements in critically ill adult patients, SPN may be beneficial as it helps in decreasing nosocomial infections and ICU mortality, in addition to increasing energy and protein intakes with no negative effects on other clinical outcomes.https://www.mdpi.com/2072-6643/12/10/2968supplemental parenteral nutritionintensive careclinical outcomes |
| spellingShingle | Dalal J. Alsharif Farah J. Alsharif Ghadeer S. Aljuraiban Mahmoud M. A. Abulmeaty Effect of Supplemental Parenteral Nutrition Versus Enteral Nutrition Alone on Clinical Outcomes in Critically Ill Adult Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Nutrients supplemental parenteral nutrition intensive care clinical outcomes |
| title | Effect of Supplemental Parenteral Nutrition Versus Enteral Nutrition Alone on Clinical Outcomes in Critically Ill Adult Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_full | Effect of Supplemental Parenteral Nutrition Versus Enteral Nutrition Alone on Clinical Outcomes in Critically Ill Adult Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_fullStr | Effect of Supplemental Parenteral Nutrition Versus Enteral Nutrition Alone on Clinical Outcomes in Critically Ill Adult Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_full_unstemmed | Effect of Supplemental Parenteral Nutrition Versus Enteral Nutrition Alone on Clinical Outcomes in Critically Ill Adult Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_short | Effect of Supplemental Parenteral Nutrition Versus Enteral Nutrition Alone on Clinical Outcomes in Critically Ill Adult Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_sort | effect of supplemental parenteral nutrition versus enteral nutrition alone on clinical outcomes in critically ill adult patients a systematic review and meta analysis of randomized controlled trials |
| topic | supplemental parenteral nutrition intensive care clinical outcomes |
| url | https://www.mdpi.com/2072-6643/12/10/2968 |
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