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

Abstract

Objective. The purpose of this research was to rigorously assess the impact of early low-fever enteral feeding supplementation in critically sick patients. Methods. PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and Physiotherapy Evidence Database were searched for randomized controlled trials related to enteral nutrition support of critically ill patients (retrieval time was limited to June 30, 2021); data were extracted after screening the literature, and the quality of meta-analysis was evaluated. Results. When compared to adequate caloric enteral nutrition support, early low caloric enteral nutrition support reduces the incidence of intolerance to nutrition support ( $\text{MD}=0.60$ , 95 percent CI: -0.18 to 1.39, $P=0.13$ ) and the insulin dose during enteral nutrition support ( $\text{MD}=-17.21$ , 95 percent CI: -19.91 to -14.51, $P=0.00001$ ). However, it had no effect on intensive care unit (ICU) treatment duration ( $\text{MD}=0.60$ , 95 percent CI: -0.18 to 1.39, $P=0.13$ ), in-hospital mortality ( $\text{MD}=0.60$ , 95 percent CI: -0.18 to 1.39, $P=0.13$ ), or infection incidence ( $\text{OR}=1.00$ , 95 percent CI: 0.85, 1.19, $P=0.98$ ). Conclusion. When compared to sufficient caloric enteral nutrition support, early low-calorie enteral nutrition support lowers the risk of severe illness. The rate of intolerance to nutritional assistance and the decrease in insulin dosage supplied had no effect on the length of ICU therapy, patient death, or infection incidence.