Nutrients, Vol. 17, Pages 10: Comparison of Early Enteral Nutrition Versus Early Parenteral Nutrition in Critically Ill Patients: A Systematic Review and Meta-Analysis
Nutrients doi: 10.3390/nu17010010
Authors:
Seung Min Baik
Mina Kim
Jae Gil Lee
Background: Nutritional support is crucial in critically ill patients to enhance recovery, reduce infections, and improve outcomes. This meta-analysis compared early enteral nutrition (EEN) and early parenteral nutrition (EPN) to evaluate their efficacy in adult critically ill patients. Methods: A systematic review of 14 studies involving 7618 patients was conducted, including randomized controlled trials, prospective cohorts, and retrospective analyses. The primary outcomes were mortality and infectious complications, while secondary outcomes included intensive care unit length of stay (ICU-LOS), hospital length of stay (H-LOS), mechanical ventilation days, and gastrointestinal (GI) complications. Results: The results showed no significant difference in mortality between EEN and EPN (OR 1.03, 95% CI 0.93–1.14). EEN reduced bloodstream infections (OR 0.73, 95% CI 0.57–0.93), ICU-LOS (MD −0.18 days, 95% CI −0.33 to −0.04), and H-LOS (MD −1.15 days, 95% CI −1.38 to −0.93). However, EEN was associated with higher GI complications, such as vomiting and diarrhea (OR 2.25, 95% CI 1.97–2.58), while mechanical ventilation days showed no significant difference. Conclusions: These findings support prioritizing EEN in critically ill patients with functional gastrointestinal systems to improve infection control and recovery while emphasizing the importance of careful monitoring to mitigate gastrointestinal complications.
Background: Nutritional support is crucial in critically ill patients to enhance recovery, reduce infections, and improve outcomes. This meta-analysis compared early enteral nutrition (EEN) and early parenteral nutrition (EPN) to evaluate their efficacy in adult critically ill patients. Methods: A systematic review of 14 studies involving 7618 patients was conducted, including randomized controlled trials, prospective cohorts, and retrospective analyses. The primary outcomes were mortality and infectious complications, while secondary outcomes included intensive care unit length of stay (ICU-LOS), hospital length of stay (H-LOS), mechanical ventilation days, and gastrointestinal (GI) complications. Results: The results showed no significant difference in mortality between EEN and EPN (OR 1.03, 95% CI 0.93–1.14). EEN reduced bloodstream infections (OR 0.73, 95% CI 0.57–0.93), ICU-LOS (MD −0.18 days, 95% CI −0.33 to −0.04), and H-LOS (MD −1.15 days, 95% CI −1.38 to −0.93). However, EEN was associated with higher GI complications, such as vomiting and diarrhea (OR 2.25, 95% CI 1.97–2.58), while mechanical ventilation days showed no significant difference. Conclusions: These findings support prioritizing EEN in critically ill patients with functional gastrointestinal systems to improve infection control and recovery while emphasizing the importance of careful monitoring to mitigate gastrointestinal complications. Read More