Effect of early enteral nutrition combined with probiotics in patients with stroke: a meta-analysis of randomized controlled trials

Chen, Xinrong; Hu, Yanjie; Yuan, Xingzhu; Yang, Jie; Li, Ka

doi:10.1038/s41430-021-00986-3

Cited by 28 publications

(35 citation statements)

References 50 publications

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“…For many centres EEN has been used for quite some time as an induction therapy in paediatric CD, and in most cases the clinical improvement resulting from its administration is in conjunction with other common therapies 7,24–26 . While comparative studies using PCDAI or decreased percentage of PCDAI to indicate remission, the aforementioned review included single‐arm studies to summarise change of PCDAI, demonstrated the change of −27.24, and the clinician importance in terms of remission or clinical response in children with Crohn's disease.…”

Section: Discussionmentioning

confidence: 99%

“…For many centres EEN has been used for quite some time as an induction therapy in paediatric CD, and in most cases the clinical improvement resulting from its administration is in conjunction with other common therapies. 7,[24][25][26] While comparative studies using Regarding growth factors albumin, calprotectin, the effect of the polymeric formula was more significant than an elemental formula.…”

Section: Discussionmentioning

confidence: 99%

“…Chen et al recently conducted a recent study to evaluate the effects of EEN on 2216 stroke patients with high levels of inflammation. The results showed that EEN significantly reduced gastrointestinal complications, shorter inpatient stay, higher albumin levels, and increased safety and anthropometric factors 24. Another meta-analysis study in 2017 included eight studies to compare the…”

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confidence: 99%

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Meta‐analysis: efficacy of exclusive enteral nutrition as induction therapy on disease activity index, inflammation and growth factors in paediatric Crohn’s disease

Sohouli

Fatahi

Farahmand

et al. 2022

Aliment Pharmacol Ther

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Summary Background There is evidence of inconsistency in sequelae of exclusive enteral nutrition (EEN) as induction therapy in paediatric patients with Crohn's disease (CD). Aim To investigate the potential effects of EEN on paediatric Crohn's disease activity index (PCDAI), inflammation and biochemical parameters in paediatric patients with CD. Methods We performed a comprehensive systematic search of PubMed/MEDLINE, Web of Science, SCOPUS and Embase until 8 January 2022 regardless of the time of publication or language. Random‐effects model was applied to combine the datasets. The main outcomes were analysed through mean difference (MD) and its 95% confidence interval (CI). Results Forty six studies met eligibility criteria and were included in the meta‐analysis. Pooled findings indicated that PCDAI score (MD of −27.24; 95% CI −31.84 to −22.64), calprotectin (MD of −842.83 mg/kg; CI −1018.24 to −667.42), CRP (pooled MD of −2.36 mg/dl; CI −2.68 to −2.03), and ESR (MD of −21.09 mm/h; CI −23.79 to −18.38), albumin (MD of 0.65 g/dl; CI 0.58 to 0.72), haemoglobin (MD of 1.12 g/dl; CI 0.87 to 1.37), weight (MD of 4.30 kg; CI 3.39 to 5.22), and height (MD of 0.98 cm; CI 0.35 to 1.62) improved significantly with EEN. Conclusions Adherence to EEN can have significant, beneficial effects as induction therapy in paediatric patients with CD.

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Section: Discussionmentioning

confidence: 99%

“…For many centres EEN has been used for quite some time as an induction therapy in paediatric CD, and in most cases the clinical improvement resulting from its administration is in conjunction with other common therapies. 7,[24][25][26] While comparative studies using Regarding growth factors albumin, calprotectin, the effect of the polymeric formula was more significant than an elemental formula.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Meta‐analysis: efficacy of exclusive enteral nutrition as induction therapy on disease activity index, inflammation and growth factors in paediatric Crohn’s disease

Sohouli

Fatahi

Farahmand

et al. 2022

Aliment Pharmacol Ther

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“…EEN combined with probiotics has been reported to improve the nutritional status of patients with IS via regulation of the intestinal flora and intestinal mucosal barrier function, which reduces the incidence of infectious complications and gastrointestinal motility disorders. 23 Hence, EEN might also reduce SAP risk in patients with acute IS by maintaining systemic immune function. In contrast, the associations of dysarthria and cardiogenic cerebral infarction are newly revealed.…”

Section: Discussionmentioning

confidence: 99%

Effect of early enteral nutrition on critical care outcomes in patients with acute ischemic stroke

et al. 2021

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Objective Stroke-associated pneumonia (SAP) is a comorbidity of ischemic stroke related to clinical outcomes. Early enteral nutrition (EEN; within 48 hours) reduces the incidence of infection and length of intensive care unit (ICU)/hospital stay. The relationship between EEN and critical care outcomes, including SAP, in patients with ischemic stroke has been insufficiently studied. Methods We recruited 499 patients in this retrospective observational study. We evaluated SAP incidence within 14 days from admission. Patients were divided into an EEN group and a late EN group (LEN; start later than EEN). We compared groups regarding background and length of ICU/hospital stay. Results EN was started within 48 hours in 236 patients. SAP was diagnosed in 94 patients (18.8%), with most in the LEN group (28.1% vs. 8.5%). Median [interquartile range] lengths of hospitalization (22 [12–30] days vs. 35 [20–45] days) and ICU stay (4 [2–5] days vs. 6 [3–8] days) were longer in the LEN group. EEN reduced the incidence of SAP. By contrast, consciousness disturbance and worsening consciousness level increased the SAP incidence. Increased age and National Institutes of Health Stroke Scale score were associated with start of prolonged EN. Conclusions We found that EEN may reduce SAP risk.

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“…Moreover, probiotics have been found to inhibit neuronal apoptosis [30,31,32], which correlates with results from previous studies. Probiotics can also play a role in the immunologic pathway of the brain and decrease changes within the hippocampus [27,29,31].…”

Section: Histopathologymentioning

confidence: 99%

Probiotic as A Potential Gut Microbiome Modifier for Stroke Treatment: A Systematic Scoping Review of <i>in vitro</i> and <i>in vivo</i> Studies

Savigamin¹,

Samuthpongtorn²,

Mahakit³

et al. 2022

Preprint

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Background: Pharmacologic and non-pharmacologic treatments for stroke are essential but could be costly or harmful whereas probiotic has been a promising alternative. This scoping review aimed to synthesize the in vitro and in vivo evidence of probiotics on stroke-related neurological, biochemical, and histochemical outcomes. Method: We searched in PubMed, Embase, and Cochrane Central Register of Clinical up to May 7, 2021, and screened by two independent reviewers. We included the use of probiotics, prebiotics, and symbiotics both in vitro and in vivo for the prevention or treatment of the stroke-related model. Result: Of 6,293 articles, 4,990 passed the initial screen, of which 36 theme-related full-texts were assessed and 13 were included in this review. Probiotics could ameliorate the neurological deficit and show their property as an anti-inflammation and anti-oxidative stress. Histopathologically decreased loss of cerebral volume and inhibition of neuronal apoptosis were found. Conclusion: There are potential cognitive benefits of probiotic supplementation, especially among animal models, on decreasing cerebral volume, increasing neurological score, and decreasing the inflammatory response. However, further investigation is needed to validate these conclusions in various populations.

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Effect of early enteral nutrition combined with probiotics in patients with stroke: a meta-analysis of randomized controlled trials

Cited by 28 publications

References 50 publications

Meta‐analysis: efficacy of exclusive enteral nutrition as induction therapy on disease activity index, inflammation and growth factors in paediatric Crohn’s disease

Meta‐analysis: efficacy of exclusive enteral nutrition as induction therapy on disease activity index, inflammation and growth factors in paediatric Crohn’s disease

Effect of early enteral nutrition on critical care outcomes in patients with acute ischemic stroke

Probiotic as A Potential Gut Microbiome Modifier for Stroke Treatment: A Systematic Scoping Review of <i>in vitro</i> and <i>in vivo</i> Studies

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