Early enteral nutrition, provided within 24 h of injury or intensive care unit admission, significantly reduces mortality in critically ill patients: a meta-analysis of randomised controlled trials.

摘要: To determine whether the provision of early standard enteral nutrition (EN) confers treatment benefits to critically ill patients. Medline and EMBASE were searched. Hand citation review retrieved guidelines systematic reviews undertaken, academic industry experts contacted. Methodologically sound randomised controlled trials (RCTs) conducted in patient populations that compared delivery EN, provided within 24 h intensive care unit (ICU) admission or injury, included. The primary analysis was on clinically meaningful patient-oriented outcomes. Secondary analyses considered vomiting/regurgitation, pneumonia, bacteraemia, sepsis multiple organ dysfunction syndrome. Meta-analyses using odds ratio (OR) metric a fixed effects model. impact heterogeneity assessed I 2 metric. Six RCTs with 234 participants analysed. EN associated significant reduction mortality [OR = 0.34, 95% confidence interval (CI) 0.14–0.85] pneumonia (OR = 0.31, CI 0.12–0.78). There no other differences A sensitivity simulation exercise confirmed presence reduction. Although detection statistically is promising, overall trial quality low, size small, findings may be restricted groups enrolled into included trials. results this meta-analysis should by conduct large multi-centre enrolling diverse groups.