Optimizing enteral nutrition delivery by implementing volume-based feeding protocol for critically ill patients: an updated meta-analysis and systematic review
Abstract Background This study aims to provide an updated assessment of the efficacy of optimized enteral nutrition (EN) delivery by implementing the volume-based feeding (VBF) protocol in critically ill patients. Methods We updated our previous literature retrieval with no language restrictions. Th...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | Critical Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13054-023-04439-0 |
| _version_ | 1827952751834824704 |
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| author | Lu Wang Yu Wang Hua-Xin Li Rui-peng Zhang Li Chang Jun Zeng Hua Jiang |
| author_facet | Lu Wang Yu Wang Hua-Xin Li Rui-peng Zhang Li Chang Jun Zeng Hua Jiang |
| author_sort | Lu Wang |
| collection | DOAJ |
| description | Abstract Background This study aims to provide an updated assessment of the efficacy of optimized enteral nutrition (EN) delivery by implementing the volume-based feeding (VBF) protocol in critically ill patients. Methods We updated our previous literature retrieval with no language restrictions. The inclusion criteria were:1) Participants: Critically ill patients (Patients who was admitted in ICU; 2) Intervention: The VBF protocol was adopted for EN administration; 3) Comparison: The rate-based feeding (RBF) protocol was adopted for EN administration; 4) Major outcomes: EN nutrition delivery. The exclusion criteria included participants aged < 18 years, duplicated literature, animal and cellular experiments, and studies lacking any of the outcomes mentioned in the inclusion criteria. The databases included MEDLINE (through PubMed), Web of Science, Cochrane Library, Chinese Biomedical Literature Service System (SinoMed), Wanfang Data Knowledge Service Platform, and China National Knowledge Infrastructure. Result Sixteen studies involving a total of 2896 critically ill patients are included in the updated meta-analysis. Compared with the previous meta-analysis, nine new studies were added that included 2205 more patients. The VBF protocol significantly improved energy (MD = 15.41%, 95% CI: [10.68, 20.14], p < 0.00001) and protein (MD = 22.05%, 95% CI: [10.89, 33.22], p = 0.0001) delivery. The patients in the VBF group stayed in the ICU for a shorter time (MD = 0.78, 95% CI: [0.01, 1.56], p = 0.05). The VBF protocol did not increase the risk of death (RR = 1.03, 95% CI: [0.85, 1.24], p = 0.76) or prolong the mechanical ventilation duration (MD = 0.81, 95% CI: [-0.30,1.92], p = 0.15). In addition, the VBF protocol did not affect EN complications, such as diarrhea (RR = 0.91, 95% CI: [0.73, 1.15], p = 0.43), emesis (RR = 1.23, 95% CI: [0.76, 1.99], p = 0.41), feeding intolerance (RR = 1.14, 95% CI: [0.63, 2.09], p = 0.66), and gastric retention (RR = 0.45, 95% CI: [0.16, 1.30], p = 0.14). Conclusion Our study revealed that the VBF protocol significantly improved calorie and protein delivery in critically ill patients with no additional risk. |
| first_indexed | 2024-04-09T14:02:31Z |
| format | Article |
| id | doaj.art-bbbcfe205a394d76bc98ea24d38fbf9b |
| institution | Directory Open Access Journal |
| issn | 1364-8535 |
| language | English |
| last_indexed | 2024-04-09T14:02:31Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Critical Care |
| spelling | doaj.art-bbbcfe205a394d76bc98ea24d38fbf9b2023-05-07T11:14:35ZengBMCCritical Care1364-85352023-05-0127111410.1186/s13054-023-04439-0Optimizing enteral nutrition delivery by implementing volume-based feeding protocol for critically ill patients: an updated meta-analysis and systematic reviewLu Wang0Yu Wang1Hua-Xin Li2Rui-peng Zhang3Li Chang4Jun Zeng5Hua Jiang6Institute for Emergency and Disaster Medicine, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of ChinaInstitute for Emergency and Disaster Medicine, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of ChinaInstitute for Emergency and Disaster Medicine, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of ChinaInstitute for Emergency and Disaster Medicine, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of ChinaDepartment of Emergency Intensive Care Unit, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of ChinaInstitute for Emergency and Disaster Medicine, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of ChinaInstitute for Emergency and Disaster Medicine, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of ChinaAbstract Background This study aims to provide an updated assessment of the efficacy of optimized enteral nutrition (EN) delivery by implementing the volume-based feeding (VBF) protocol in critically ill patients. Methods We updated our previous literature retrieval with no language restrictions. The inclusion criteria were:1) Participants: Critically ill patients (Patients who was admitted in ICU; 2) Intervention: The VBF protocol was adopted for EN administration; 3) Comparison: The rate-based feeding (RBF) protocol was adopted for EN administration; 4) Major outcomes: EN nutrition delivery. The exclusion criteria included participants aged < 18 years, duplicated literature, animal and cellular experiments, and studies lacking any of the outcomes mentioned in the inclusion criteria. The databases included MEDLINE (through PubMed), Web of Science, Cochrane Library, Chinese Biomedical Literature Service System (SinoMed), Wanfang Data Knowledge Service Platform, and China National Knowledge Infrastructure. Result Sixteen studies involving a total of 2896 critically ill patients are included in the updated meta-analysis. Compared with the previous meta-analysis, nine new studies were added that included 2205 more patients. The VBF protocol significantly improved energy (MD = 15.41%, 95% CI: [10.68, 20.14], p < 0.00001) and protein (MD = 22.05%, 95% CI: [10.89, 33.22], p = 0.0001) delivery. The patients in the VBF group stayed in the ICU for a shorter time (MD = 0.78, 95% CI: [0.01, 1.56], p = 0.05). The VBF protocol did not increase the risk of death (RR = 1.03, 95% CI: [0.85, 1.24], p = 0.76) or prolong the mechanical ventilation duration (MD = 0.81, 95% CI: [-0.30,1.92], p = 0.15). In addition, the VBF protocol did not affect EN complications, such as diarrhea (RR = 0.91, 95% CI: [0.73, 1.15], p = 0.43), emesis (RR = 1.23, 95% CI: [0.76, 1.99], p = 0.41), feeding intolerance (RR = 1.14, 95% CI: [0.63, 2.09], p = 0.66), and gastric retention (RR = 0.45, 95% CI: [0.16, 1.30], p = 0.14). Conclusion Our study revealed that the VBF protocol significantly improved calorie and protein delivery in critically ill patients with no additional risk.https://doi.org/10.1186/s13054-023-04439-0Intensive care unitEnteral nutritionVolume-based feedingRate-based feeding |
| spellingShingle | Lu Wang Yu Wang Hua-Xin Li Rui-peng Zhang Li Chang Jun Zeng Hua Jiang Optimizing enteral nutrition delivery by implementing volume-based feeding protocol for critically ill patients: an updated meta-analysis and systematic review Critical Care Intensive care unit Enteral nutrition Volume-based feeding Rate-based feeding |
| title | Optimizing enteral nutrition delivery by implementing volume-based feeding protocol for critically ill patients: an updated meta-analysis and systematic review |
| title_full | Optimizing enteral nutrition delivery by implementing volume-based feeding protocol for critically ill patients: an updated meta-analysis and systematic review |
| title_fullStr | Optimizing enteral nutrition delivery by implementing volume-based feeding protocol for critically ill patients: an updated meta-analysis and systematic review |
| title_full_unstemmed | Optimizing enteral nutrition delivery by implementing volume-based feeding protocol for critically ill patients: an updated meta-analysis and systematic review |
| title_short | Optimizing enteral nutrition delivery by implementing volume-based feeding protocol for critically ill patients: an updated meta-analysis and systematic review |
| title_sort | optimizing enteral nutrition delivery by implementing volume based feeding protocol for critically ill patients an updated meta analysis and systematic review |
| topic | Intensive care unit Enteral nutrition Volume-based feeding Rate-based feeding |
| url | https://doi.org/10.1186/s13054-023-04439-0 |
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