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Systematic Review With Meta-Analysis of Patient-Centered Outcomes, Comparing International Guideline-Recommended Enteral Protein Delivery With Usual Care.
- Source :
- JPEN Journal of Parenteral & Enteral Nutrition; May2020, Vol. 44 Issue 4, p610-620, 11p
- Publication Year :
- 2020
-
Abstract
- <bold>Background: </bold>International guidelines recommend that protein be administered enterally to critically ill patients at doses between 1.2 and 2 g/kg per day Observational data indicate that patients frequently receive less protein. The aim of this systematic review was to evaluate patient-centered outcomes with guideline-recommended enteral protein compared with usual care.<bold>Methods: </bold>A systematic review was performed of randomized controlled trials including critically ill adult patients provided predominately enteral nutrition with mean protein at ≥1.2 g/kg per day (intervention) and <1.2 g/kg per day (comparator). Random-effects models were applied for outcomes reported in ≥3 trials.<bold>Results: </bold>Of 1375 abstracts, 69 full-text articles were reviewed, and 6 trials meet the inclusion criteria, including 511 patients. The intervention group received a mean (SD) of 1.3 (0.08) g/kg per day, and the comparator group received 0.75 (0.15) g/kg per day protein. Insufficient data were available for meta-analyses on the primary outcome (muscle mass or strength). According to our meta-analyses, mortality at 28 days (5 studies) (risk ratio 0.92 [95% Cl 0.63-1.35], P = .66) and the durations of intensive care unit (6 studies) and hospital admission (4 studies) were similar between the intervention and comparator, with some uncertainty due to sample sizes and heterogeneity.<bold>Conclusion: </bold>There are insufficient data to conclude whether protein provision within the current international guideline recommendations improves outcomes. In a limited dataset, enteral protein intakes near the lower level of current recommendations do not appear to reduce admission duration or mortality when compared with usual care in critically ill. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 01486071
- Volume :
- 44
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- JPEN Journal of Parenteral & Enteral Nutrition
- Publication Type :
- Academic Journal
- Accession number :
- 143117819
- Full Text :
- https://doi.org/10.1002/jpen.1725