The incidence and influencing factors of early enteral nutritional feeding interruptions in critically ill patients: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

YANG Xiaojuan ^1,2 ,  WANG Jing ^2,3 , ZOU Xiaocui ^2,4 , LI Wei ^1,2 , LI Rong ^2,5 , MAO Xiaorong ^2,6 , WEN Qing ^2,7 , XU Chunyi ¹ , FAN Yu ²

1. Department of Burns, Sichuan Provincial People's Hospital, Chengdu 610072, P. R. China;
2. School of Medicine, University of Electronic Science and Technology of China, Chengdu 610054, P. R. China;
3. Department of Nutrition, Sichuan Provincial People's Hospital, Chengdu 610072, P. R. China;
4. Department of Hepatobiliary, Sichuan Provincial People's Hospital, Chengdu 610072, P. R. China;
5. Department of Maternity, Sichuan Provincial People's Hospital, Chengdu 610072, P. R. China;
6. Department of Nursing, Sichuan Provincial People's Hospital, Chengdu 610072, P. R. China;
7. Cardiac Intensive Care Unit, Sichuan Provincial People's Hospital, Chengdu 610072, P. R. China;

Corresponding?author：

WANG Jing, Email: 965556018@qq.com

Keywords：

Critically ill patients; Early enteral nutrition; Feeding interruptions; Incidence; Influencing factors; Meta-analysis

DOI：

10.7507/1672-2531.202402018

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the incidence and influencing factors of early enteral nutritional feeding interruptions in critically ill patients. Methods The PubMed, Web of Science, Embase, Cochrane Library, CNKI, WanFang Data and CBM databases were electronically searched to collect observational studies on the early enteral nutritional feeding interruptions in critically ill patients from inception to January 2, 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 17.0 software. Results A total of 12 studies including 1 121 patients were included. Meta-analysis showed that the incidence of early enteral nutritional feeding interruptions in critically ill patients was 75.0% (95%CI 64.0% to 84.0%). Influenced by feeding intolerance, airway management, tube problems, radiological examination, and endoscopy, surgery and so on, interruptions of early enteral nutritional feeding frequently occur in critically ill patients. Conclusion Current evidence shows that early enteral feeding interruptions in critically ill patients are affected by many factors, and the incidence is high. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.

Citation： YANG Xiaojuan, WANG Jing, ZOU Xiaocui, LI Wei, LI Rong, MAO Xiaorong, WEN Qing, XU Chunyi, FAN Yu. The incidence and influencing factors of early enteral nutritional feeding interruptions in critically ill patients: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2024, 24(8): 921-925. doi: 10.7507/1672-2531.202402018 Copy

1.	Reintam Blaser A, Starkopf J, Alhazzani W, et al. Early enteral nutrition in critically ill patients: ESICM clinical practice guidelines. Intensive Care Med, 2017, 43(3): 380-398.
2.	孫仁華, 江榮林, 黃曼, 等. 重癥患者早期腸內營養臨床實踐專家共識. 中華危重病急救醫學, 2018, 30(8): 715-721.
3.	McClave SA, DiBaise JK, Mullin GE, et al. ACG clinical guideline: nutrition therapy in the adult hospitalized patient. Am J Gastroenterol, 2016, 111(3): 315-334.
4.	左俊燾, 李嘉琪, 徐瑤, 等. 重癥病人腸內營養中斷現狀及其對熱卡達標的影響研究. 腸外與腸內營養, 2023, 30(3): 166-170.
5.	Onuk S, Ozer NT, Savas N, et al. Enteral nutrition interruptions in critically ill patients: a prospective study on reasons, frequency and duration of interruptions of nutritional support during ICU stay. Clin Nutr ESPEN, 2022, 52: 178-183.
6.	Kasti AN, Theodorakopoulou M, Katsas K, et al. Factors associated with interruptions of enteral nutrition and the impact on macro- and micronutrient deficits in ICU patients. Nutrients, 2023, 15(4): 917.
7.	Padar M, Uusvel G, Starkopf L, et al. Implementation of enteral feeding protocol in an intensive care unit: before-and-after study. World J Crit Care Med, 2017, 6(1): 56-64.
8.	李陽洋, 邵小平, 蔣卓娟, 等. 早期腸內營養集束化喂養方案對重癥患者營養熱卡達標率及喂養不耐受的效果研究. 軍事護理, 2022, 39(9): 41-44.
9.	宮雪梅, 葉向紅, 邢娟, 等. 重癥病人早期腸內營養喂養中斷原因的系統評價. 腸外與腸內營養, 2018, 25(5): 285-290.
10.	曾憲濤, 劉慧, 陳曦, 等. Meta分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
11.	程志強, 張寶珍, 李夏欣, 等. 危重癥患者ICU后心理功能障礙發生率及危險因素的Meta分析. 軍事護理, 2023, 40(8): 77-81.
12.	王丹, 翟俊霞, 牟振云, 等. Meta分析中的異質性及其處理方法. 中國循證醫學雜志, 2009, 9(10): 1115-1118.
13.	Doleman B, Freeman SC, Lund JN, et al. Funnel plots may show asymmetry in the absence of publication bias with continuous outcomes dependent on baseline risk: presentation of a new publication bias test. Res Synth Methods, 2020, 11(4): 522-534.
14.	韓珍, 葉向紅, 張銳, 等. 普外科重癥患者腸內營養中斷影響因素分析及對預后影響的研究. 中國實用護理雜志, 2022, 38(28): 2203-2208.
15.	van Nieuwkoop MM, Ramnarain D, Pouwels S. Enteral nutrition interruptions in the intensive care unit: a prospective study. Nutrition, 2022, 96: 111580.
16.	Habib M, Murtaza HG, Kharadi N, et al. Interruptions to enteral nutrition in critically ill patients in the intensive care unit. Cureus, 2022, 14(3): e22821.
17.	李娜. 重癥神經系統疾病患者喂養不耐受現狀及影響因素分析. 蘭州: 蘭州大學, 2021.
18.	Salciute-Simene E, Stasiunaitis R, Ambrasas E, et al. Impact of enteral nutrition interruptions on underfeeding in intensive care unit. Clin Nutr, 2021, 40(3): 1310-1317.
19.	宮雪梅, 葉向紅, 武燕, 等. 重癥患者早期腸內營養喂養中斷現狀的調查研究. 中華現代護理雜志, 2019, 25(13): 1646-1650.
20.	Peev MP, Yeh DD, Quraishi SA, et al. Causes and consequences of interrupted enteral nutrition: a prospective observational study in critically ill surgical patients. JPEN J Parenter Enteral Nutr, 2015, 39(1): 21-27.
21.	Czapran A, Headdon W, Deane AM, et al. International observational study of nutritional support in mechanically ventilated patients following burn injury. Burns, 2015, 41(3): 510-518.
22.	Yip KF, Rai V, Wong KK. Evaluation of delivery of enteral nutrition in mechanically ventilated Malaysian ICU patients. BMC Anesthesiol, 2014, 14: 127.
23.	Kim H, Stotts NA, Froelicher ES, et al. Enteral nutritional intake in adult korean intensive care patients. Am J Crit Care, 2013, 22(2): 126-135.
24.	Rice TW, Swope T, Bozeman S, et al. Variation in enteral nutrition delivery in mechanically ventilated patients. Nutrition, 2005, 21(7-8): 786-792.
25.	米元元, 盧潔. 重癥患者腸內營養中斷影響因素及干預策略的研究進展. 護士進修雜志, 2022, 37(10): 886-891.
26.	黃培培, 蔡喆燚, 田飛, 等. ICU腸內營養中斷現況調查及影響因素分析. 護士進修雜志, 2023, 38(18): 1704-1709.
27.	米元元. ICU醫護人員腸內營養中斷知信行量表的編制與應用. 鄭州: 鄭州大學, 2022.
28.	Adam A, Ibrahim NA, Tah PC, et al. Decision tree model for early use of semi-elemental formula versus standard polymeric formula in critically ill Malaysian patients: a cost-effectiveness study. JPEN J Parenter Enteral Nutr, 2023, 47(8): 1003-1010.
29.	Shahmanyan D, Lawrence JC, Lollar DI, et al. Early feeding after percutaneous endoscopic gastrostomy tube placement in patients who require trauma and surgical intensive care: a retrospective cohort study. JPEN J Parenter Enteral Nutr, 2022, 46(5): 1160-1166.
30.	McCall ME, Adamo A, Latko K, et al. Maximizing nutrition support practice and measuring adherence to nutrition support guidelines in a Canadian tertiary care ICU. J Intensive Care Med, 2018, 33(3): 209-217.
31.	Kozeniecki M, McAndrew N, Patel JJ. Process-related barriers to optimizing enteral nutrition in a tertiary medical intensive care unit. Nutr Clin Pract, 2016, 31(1): 80-85.

1. Reintam Blaser A, Starkopf J, Alhazzani W, et al. Early enteral nutrition in critically ill patients: ESICM clinical practice guidelines. Intensive Care Med, 2017, 43(3): 380-398.
2. 孫仁華, 江榮林, 黃曼, 等. 重癥患者早期腸內營養臨床實踐專家共識. 中華危重病急救醫學, 2018, 30(8): 715-721.
3. McClave SA, DiBaise JK, Mullin GE, et al. ACG clinical guideline: nutrition therapy in the adult hospitalized patient. Am J Gastroenterol, 2016, 111(3): 315-334.
4. 左俊燾, 李嘉琪, 徐瑤, 等. 重癥病人腸內營養中斷現狀及其對熱卡達標的影響研究. 腸外與腸內營養, 2023, 30(3): 166-170.
5. Onuk S, Ozer NT, Savas N, et al. Enteral nutrition interruptions in critically ill patients: a prospective study on reasons, frequency and duration of interruptions of nutritional support during ICU stay. Clin Nutr ESPEN, 2022, 52: 178-183.
6. Kasti AN, Theodorakopoulou M, Katsas K, et al. Factors associated with interruptions of enteral nutrition and the impact on macro- and micronutrient deficits in ICU patients. Nutrients, 2023, 15(4): 917.
7. Padar M, Uusvel G, Starkopf L, et al. Implementation of enteral feeding protocol in an intensive care unit: before-and-after study. World J Crit Care Med, 2017, 6(1): 56-64.
8. 李陽洋, 邵小平, 蔣卓娟, 等. 早期腸內營養集束化喂養方案對重癥患者營養熱卡達標率及喂養不耐受的效果研究. 軍事護理, 2022, 39(9): 41-44.
9. 宮雪梅, 葉向紅, 邢娟, 等. 重癥病人早期腸內營養喂養中斷原因的系統評價. 腸外與腸內營養, 2018, 25(5): 285-290.
10. 曾憲濤, 劉慧, 陳曦, 等. Meta分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
11. 程志強, 張寶珍, 李夏欣, 等. 危重癥患者ICU后心理功能障礙發生率及危險因素的Meta分析. 軍事護理, 2023, 40(8): 77-81.
12. 王丹, 翟俊霞, 牟振云, 等. Meta分析中的異質性及其處理方法. 中國循證醫學雜志, 2009, 9(10): 1115-1118.
13. Doleman B, Freeman SC, Lund JN, et al. Funnel plots may show asymmetry in the absence of publication bias with continuous outcomes dependent on baseline risk: presentation of a new publication bias test. Res Synth Methods, 2020, 11(4): 522-534.
14. 韓珍, 葉向紅, 張銳, 等. 普外科重癥患者腸內營養中斷影響因素分析及對預后影響的研究. 中國實用護理雜志, 2022, 38(28): 2203-2208.
15. van Nieuwkoop MM, Ramnarain D, Pouwels S. Enteral nutrition interruptions in the intensive care unit: a prospective study. Nutrition, 2022, 96: 111580.
16. Habib M, Murtaza HG, Kharadi N, et al. Interruptions to enteral nutrition in critically ill patients in the intensive care unit. Cureus, 2022, 14(3): e22821.
17. 李娜. 重癥神經系統疾病患者喂養不耐受現狀及影響因素分析. 蘭州: 蘭州大學, 2021.
18. Salciute-Simene E, Stasiunaitis R, Ambrasas E, et al. Impact of enteral nutrition interruptions on underfeeding in intensive care unit. Clin Nutr, 2021, 40(3): 1310-1317.
19. 宮雪梅, 葉向紅, 武燕, 等. 重癥患者早期腸內營養喂養中斷現狀的調查研究. 中華現代護理雜志, 2019, 25(13): 1646-1650.
20. Peev MP, Yeh DD, Quraishi SA, et al. Causes and consequences of interrupted enteral nutrition: a prospective observational study in critically ill surgical patients. JPEN J Parenter Enteral Nutr, 2015, 39(1): 21-27.
21. Czapran A, Headdon W, Deane AM, et al. International observational study of nutritional support in mechanically ventilated patients following burn injury. Burns, 2015, 41(3): 510-518.
22. Yip KF, Rai V, Wong KK. Evaluation of delivery of enteral nutrition in mechanically ventilated Malaysian ICU patients. BMC Anesthesiol, 2014, 14: 127.
23. Kim H, Stotts NA, Froelicher ES, et al. Enteral nutritional intake in adult korean intensive care patients. Am J Crit Care, 2013, 22(2): 126-135.
24. Rice TW, Swope T, Bozeman S, et al. Variation in enteral nutrition delivery in mechanically ventilated patients. Nutrition, 2005, 21(7-8): 786-792.
25. 米元元, 盧潔. 重癥患者腸內營養中斷影響因素及干預策略的研究進展. 護士進修雜志, 2022, 37(10): 886-891.
26. 黃培培, 蔡喆燚, 田飛, 等. ICU腸內營養中斷現況調查及影響因素分析. 護士進修雜志, 2023, 38(18): 1704-1709.
27. 米元元. ICU醫護人員腸內營養中斷知信行量表的編制與應用. 鄭州: 鄭州大學, 2022.
28. Adam A, Ibrahim NA, Tah PC, et al. Decision tree model for early use of semi-elemental formula versus standard polymeric formula in critically ill Malaysian patients: a cost-effectiveness study. JPEN J Parenter Enteral Nutr, 2023, 47(8): 1003-1010.
29. Shahmanyan D, Lawrence JC, Lollar DI, et al. Early feeding after percutaneous endoscopic gastrostomy tube placement in patients who require trauma and surgical intensive care: a retrospective cohort study. JPEN J Parenter Enteral Nutr, 2022, 46(5): 1160-1166.
30. McCall ME, Adamo A, Latko K, et al. Maximizing nutrition support practice and measuring adherence to nutrition support guidelines in a Canadian tertiary care ICU. J Intensive Care Med, 2018, 33(3): 209-217.
31. Kozeniecki M, McAndrew N, Patel JJ. Process-related barriers to optimizing enteral nutrition in a tertiary medical intensive care unit. Nutr Clin Pract, 2016, 31(1): 80-85.

Chinese Journal of Evidence-Based Medicine

The incidence and influencing factors of early enteral nutritional feeding interruptions in critically ill patients: a meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content