Effect of Early Low-Calorie Enteral Nutrition Support in Critically Ill Patients: A Systematic Review and Meta-analysis

Jiang, Qidong; Xu, Tao

doi:10.1155/2022/7478373

Cited by 3 publications

(2 citation statements)

References 26 publications

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“…Safe and effective feeding in burn patients must be carefully balanced because acute colonic pseudo-obstruction and severe burn-induced edema within the gastrointestinal mucosa can cause nutrient malabsorption. To facilitate the recovery of gastrointestinal motility and metabolic processes in the initial phase after burn injury, lower calorie and protein feeding methods must become more widely accepted ( 20 ). Adaptive feeding is one strategy that reflects this approach.…”

Section: Discussionmentioning

confidence: 99%

Initiation of adaptive feeding within 24 h after burn injury improves nutritional therapy for severely burned patients

Zhang,

Dou,

Yin

et al. 2024

Front. Nutr.

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Introduction and objectiveNutritional therapy is a crucial component of treatment for severely burned patients. Although overly aggressive enteral nutrition immediately after burn injury has potential risks, nutritional disruption after a severe burn can also increase infection risk and delay wound healing. For approximately six decades, the Ruijin Hospital Burn Center has used two distinct approaches for patients during the early period after burn injury: complete fasting or adaptive feeding. Notably, adaptive feeding more closely resembles enteral nutrition. In this retrospective study, we analyzed factors influencing the selection of either modality, as well as the benefits of adaptive feeding. We sought to promote adaptive feeding as a precursor to initiating enteral nutrition.Patients and methodsThis retrospective study analyzed medical data from adult patients with extensive burns between January 2009 and December 2020. All patients had been admitted to the burn department within 24 h after injury and had a burned area comprising >30% of total body surface area. Patients were divided into two groups: adaptive feeding and fasting. We examined the total burned area, full-thickness burned area, burn type, inhalation injury, start time of adaptive feeding, and start time of enteral nutrition. Outcome measures were 28-day mortality and hospital mortality.ResultsUnivariate analysis revealed significant differences in burn type, percent of total body surface area (TBSA), full-thickness burned area, and inhalation injury between the adaptive feeding and fasting groups (all p < 0.05). Linear regression analysis showed that full-thickness burned area and inhalation injury were the main factors influencing the start time of adaptive feeding in patients with severe burns (p < 0.05). After propensity score matching analysis, the results showed that the start time of enteral nutrition was significantly earlier in the adaptive feeding group (p < 0.01). However, overall mortality, 28-day mortality, and length of hospital stay did not significantly improve in the adaptive feeding group. The incidence of intolerance after enteral nutrition therapy did not significantly differ between groups.ConclusionThe results of the study showed that larger full-thickness burned areas and concomitant inhalation injury were the primary factors considered by physicians when selecting complete fasting for severely burned patients. Moreover, the results indicate that adaptive feeding improves nutritional therapy for severely burned patients by shortening the time between injury and initiation of enteral nutrition. Complete fasting due to concerns about extensive burned area and inhalation injuries does not reduce the incidence of enteral nutrition intolerance; instead, it delays the initiation of enteral nutrition.

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Section: Discussionmentioning

confidence: 99%

Initiation of adaptive feeding within 24 h after burn injury improves nutritional therapy for severely burned patients

Zhang,

Dou,

Yin

et al. 2024

Front. Nutr.

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“…BioMed Research International has retracted the article titled “Effect of Early Low-Calorie Enteral Nutrition Support in Critically Ill Patients: A Systematic Review and Meta-analysis” [ 1 ] due to concerns that the peer review process has been compromised.…”

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confidence: 99%

Retracted: Effect of Early Low‐Calorie Enteral Nutrition Support in Critically Ill Patients: A Systematic Review and Meta‐analysis

International¹

2023

BioMed Research International

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Nutritional support for patients with abdominal surgical pathology: the view of a surgeon and an anesthesiologist — opponents or allies?

Shen

Mukhacheva

2023

Clinical nutrition and metabolism

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BACKGROUND: Nutritional support in abdominal surgery is a complex section of intensive care with many contradictions, both in the available recommendations and in relation to interdisciplinary interaction. The issues of assessing nutritional status, timing of the start and methods of clinical nutrition are far from being resolved. The analysis made it possible not so much to explain who and how to feed in the intensive care unit, to prove the need for an early start of enteral nutrition, as to assess the "scale of the disaster" in the form of a lack of unity of views and low adherence to clinical recommendations. AIMS: to analyze the effectiveness of early enteral nutrition in achieving optimal results in the treatment of patients with abdominal surgical pathology, to assess the depth of knowledge and adherence to clinical recommendations of specialists providing care to this cohort of patients. MATERIALS AND METHODS: The study included 50 patients, 32 of whom started early enteral nutrition, and 18 later enteral nutrition. A survey of 41 specialists (surgeons and intensivist) from three leading hospitals in Tyumen was also conducted. The main set of clinical material was conducted on the basis of the Regional Clinical Hospital No. 1. RESULTS: The study demonstrated the advantages of early enteral nutrition over delayed nutrition by an average of 48 hours in the form of reducing the duration of hospitalization, resuscitation stage of treatment and minimizing pulmonary complications. At the same time, a survey of specialists providing assistance to this cohort of patients showed a lack of unity in tactical approaches and insufficient adherence to the existing clinical recommendations on clinical nutrition in patients with abdominal surgical pathology. CONCLUSIONS: Further research in the field of nutritional support in patients with abdominal surgical pathology should be aimed at reducing the decision-making time in favor of an earlier and combined method of nutritional support, which can be facilitated by increasing literacy and adherence to clinical recommendations of specialists at the interdisciplinary level.

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Effect of Early Low-Calorie Enteral Nutrition Support in Critically Ill Patients: A Systematic Review and Meta-analysis

Cited by 3 publications

References 26 publications

Initiation of adaptive feeding within 24 h after burn injury improves nutritional therapy for severely burned patients

Initiation of adaptive feeding within 24 h after burn injury improves nutritional therapy for severely burned patients

Retracted: Effect of Early Low‐Calorie Enteral Nutrition Support in Critically Ill Patients: A Systematic Review and Meta‐analysis

Nutritional support for patients with abdominal surgical pathology: the view of a surgeon and an anesthesiologist — opponents or allies?

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