Symptoms of GDF § | Interventional | Control | Odds Ratio [95% CI]* | P Trend | I2 (%)# |
---|---|---|---|---|---|
Nausea | 88/ 274 | 90/278 | 0.98 (0.67, 1.44) | 0.92 | 0 |
Vomiting | 62/462 | 94/447 | 0.51 (0.28, 0.94) | 45 | |
Ileus | 66/832 | 80/828 | 0.83 (0.52, 1.32) | 0.42 | 23 |
GI bleed | 15/592 | 10/587 | 1.48 (0.66, 3.35) | 0.34 | 0 |
Anastomotic leak | 44/833 | 43/867 | 1.03 (0.54, 1.96) | 0.93 | 31 |
Perforation | 7/238 | 6/234 | 1.05 (0.36, 3.09) | 0.92 | 0 |
Intestinal obstruction | 5/451 | 11/445 | 0.53 (0.20, 1.45) | 0.22 | 0 |
Symptoms of GDF§ | Intervention Enteral | Control Parenteral | Odds [95% Ratio CI]* | P Trend | I2 [%]# |
---|---|---|---|---|---|
Vomiting | 605/2388 | 350/2598 | 2.02 (1.74, 2.35) | 0 | |
Diarrhoea | 190/1508 | 421/1515 | 1.75 (0.39, 7.86) | 0.46 | 92 |
Abdominal distension | 123/1386 | 90/1390 | 1.51 (0.93, 2.45) | 0.10 | 28 |
Ileus | 52/347 | 65/347 | 0.97 (0.34, 2.76) | 0.96 | 58 |
Anastomotic leak | 28/540 | 54/545 | 0.54 (0.31, 0.95) | 14 | |
Intestinal ischaemia | 33/2493 | 16/2495 | 1.87 (0.72, 4.87) | 0.20 | 42 |
Peritonitis | 5/265 | 18/268 | 0.31 (0.11, 0.87) | 0 | |
Early | Delayed | ||||
Vomiting | 3/56 | 19/54 | 0.11 (0.03, 0.41) | 0 | |
Diarrhoea | 27/39 | 23/40 | 2.45 (0.26, 22.75) | 0.43 | 69 |
Abdominal Distension | 12/66 | 21/69 | 0.51 (0.22, 1.91) | 0.12 | 0 |
Enteral | NBM | ||||
Vomiting | 21/220 | 22/219 | 0.72 (0.18, 2.90) | 0.65 | 0 |
Abdominal Distension | 66/242 | 48/240 | 1.40 (0.75, 2.64) | 0.29 | 33 |
GI bleed | 2/133 | 2/133 | 0.99 (0.17, 5.86) | 0.99 | 0 |
Anastomotic leak | 12/244 | 24/236 | 0.46 (0.22, 0.95) | 0 |
Author | Year | Study Population | Study | Study | Study | Admission diagnosis | Experimental | Intravenous | Control | Intravenous | Dindo-Clavien |
---|---|---|---|---|---|---|---|---|---|---|---|
Brandstrup | 2003 | elective colorectal resection | surgery | RCT | 141 | postsurgical | 69 | restricted | 72 | standard | |
Holte | 2007 | elective surgery | surgery | RCT | 32 | elective colorectal surgery | 16 | restricted | 16 | liberal | |
Holte | 2007 | post-surgery | surgery | RCT | 48 | knee arthroplasty | 24 | restricted | 24 | liberal | |
Gonsalez-Fajardo | 2009 | post-surgery | surgery | RCT | 40 | vascular surgery transperitoneal aorto-iliac | 20 | restricted | 20 | standard | |
Yates | 2013 | elective surgery | surgery | RCT | 206 | elective colorectal surgery | 104 | starch | 98 | crystalloid | |
Ghodraty | 2017 | post-surgery | surgery | RCT | 91 | abdominal surgery | 46 | HES | 45 | ringers lactate | |
Gómez-Izquierdo | 2017 | post-surgery | surgery | RCT | 128 | colorectal surgery | 4 | GDFT | 64 | control |
Author | Year | Study Population | Study Setting | Study type | Study patients | Admission diagnosis | Experimental | Control | Dindo-Clavien Classification# | Quality Grading* | |||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
I | II | III | IV | ||||||||||
Hoover | 1980 | surgical | surgical | RCT | 48 | surgical | 26 EF | 22IVF | Poor | ||||
Adams | 1986 | ICU surgical | ICU | RCT | 46 | multiple trauma | 23 (EN) | 23(PN) | Poor | ||||
Moore | 1986 | major abdo trauma | surgical | RCT | 59 | surgical | 29 (EN) | 30 (PN) | Poor | ||||
Bower | 1986 | surgical | surgery | RCT | 20 | GI/pancreato-biliary surgery | 10 (EN-JeJ) | 10 (PN) | Poor | ||||
Hamoui | 1989 | surgical | surgical | RCT | 19 | major GI surgery | 11EN | 8PN | Poor | ||||
Von Meyenfeldt | 1992 | surgical | surgery | RCT | 101 | GI/colon cancer | 50 (EN) | 51(PN) | Poor | ||||
Montecalvo | 1992 | surgical | surgical | RCT | 38 | surgical | 19 NG | 19 NJ | Poor | ||||
Dunham | 1994 | critically ill | ICU | RCT | 37 | trauma | 12 (EN)+ 15 (PN) + 10(EN+PN) | Poor | |||||
Borzotta | 1994 | trauma | surgical trauma | RCT | 48 | trauma | 27 (EN) | 21(PN) | Poor | ||||
Daly | 1995 | surgical | surgical | RCT | 60 | surgical | 18ENSD; 12SD-IP; 19 ENSD-IP-OP; 11 EN-IP | Poor | |||||
Carr | 1996 | post-surgical | surgery | RCT | 28 | intestinal resection | 14(EEN) | 14(CEN) | Poor | ||||
Beier-Holgersen | 1996 | post-surgical | surgery | RCT | 60 | major abdominal surgery | 30(EEN) | 30 (placebo) | Poor | ||||
Baigrie | 1996 | post-surgical | surgery | RCT | 97 | oesophagectomy/gastrectomy | 50 (EN) | 47(PN) | Poor | ||||
VanBerge | 1997 | post-surgical | surgery | RCT | 57 | pancreatoduodenectomy | 30 (CON) | 27(CYC) | Poor | ||||
Kalfarentzos | 1997 | critically ill | ICU | RCT | 38 | Severe acute pancreatitis | 18(EN) | 20 (PN) | |||||
Heslin | 1997 | surgical | surgery | RCT | 195 | upper GI malignancy | 97 (EN) | 98(IVF) | Poor | ||||
Reynolds | 1997 | major upper GI surgery | surgical | RCT | 67 | surgical | 33 (EN) | 34(PN) | Poor | ||||
Stewart | 1998 | elective surgical | surgery | RCT | 80 | colorectal resections | 40 (EOF) | 40 (COF) | Poor | ||||
Windsor | 1998 | surgical | surgical | RCT | 34 | acute pancreatitis | 16 EN | 18PN | Poor | ||||
Singh | 1998 | surgical | surgical | RCT | 43 | surgical | 22JEJ | 21IVF | Poor | ||||
Braga | 1998 | surgical | surgical | RCT | 166 | surgical | 55 STD-EN; 55 -STD-EN enriched; 56 TPN | Poor | |||||
Taylor | 1999 | critically ill | ICU | RCT | 82 | head injury | 41TRO | 41 EN | Fair | ||||
Pupelis | 2000 | critically ill | S-ICU | RCT | 60 | severe pancreatitis/peritonitis | 30 (JEN) | 30 (Control) | Poor | ||||
Minard | 2000 | critically ill | ICU | RCT | 27 | head injury/trauma | 12(EEN) | 15(DEN) | Poor | ||||
Powell | 2000 | critically ill | ICU | RCT | 27 | severe acute pancreatitis | 13 (EN) | 14(NBM) | Poor | ||||
Kearns | 2000 | critically ill | ICU | RCT | 44 | critically ill | 23 G | 21 SI | Poor | ||||
Bozzetti | 2001 | elective surgery | surgery | RCT | 317 | GIcancer | 159(EN) | 158(PN) | Poor | ||||
Braga | 2001 | surgical | surgery | RCT | 257 | GIcancer | 126(EEN) | 131(PN) | Poor | ||||
Montejo | 2002 | critically ill | ICU | RCT | 101 | critically ill | 50 (JEN) | 51(GEN) | Poor | ||||
Davies | 2002 | critically ill | ICU | RCT | 73 | critically ill | 34 (NJ) | 39 (NG) | Poor | ||||
Bertolini | 2003 | critically ill | ICU | RCT | 39 | Sepsis | 18(EN) | 17 (PN) | Poor | ||||
Kompan | 2004 | critically ill | ICU | RCT | 52 | multiple trauma | 27(EEN) | 21(DEN) | Poor | ||||
Malhotra | 2004 | post-surgical | surgery | RCT | 164 | perforated gut and peritonitis | 83 (EN) | 81(NBM) | Poor | ||||
Kumar | 2006 | Surgical | surgical | RCT | 31 | surgical | 15 NG | 16 NJ | Poor | ||||
Nguyen | 2007 | critically ill | ICU | RCT | 31 | critically ill | 23 (NJ) | 28 (NJ) | Poor | ||||
Han-Guerts | 2007 | post-surgical | surgery | RCT | 150 | oesophagectomy | 71 (ND) | 79 (JEJ) | Poor | ||||
Descahy | 2008 | critically ill | ICU | RCT | 100 | ICU | 50EEN | 50CEN | Poor | ||||
Tien | 2009 | critically ill | ICU | RCT | 200 | ICU | 98TRO | 102 EN | Poor | ||||
Barlow | 2011 | Surgical | surgery | RCT | 121 | upper GI malignancy | 64 (EN) | 57(NBM+IVF) | Poor | ||||
Altintas | 2011 | critically ill | ICU | RCT | 71 | ICU | 30 (EN) | 41 (PN) | Poor | ||||
Rice | 2011 | Surgical | surgical | RCT | 247 | surgical | EN 123 | 124 IVF | Poor | ||||
Davies | 2013 | critically ill | ICU | RCT | 181 | ICU | 91 NJ | 89 NG | Poor | ||||
Zhu | 2013 | post-surgical | surgery | RCT | 68 | pancreaticoduodenectomy | 34(JT) | 34(NJT) | Poor | ||||
Sun | 2013 | critically ill | S-ICU | RCT | 60 | severe acute pancreatitis | 30(EEN) | 30(DEN) | Poor | ||||
Kadamani | 2014 | critically ill | ICU | RCT# | 15 | critically ill | 15 (CON) | 15 (BOL) | Poor | ||||
Boelens | 2014 | elective surgical | surgery | RCT | 123 | rectal surgery | 61(EEN) | 62(EPN) | Poor | ||||
Harvey | 2014 | critically ill | ICU | RCT | 2388 | critically ill | 1197(EN) | 1191(PN) | Poor | ||||
Ma | 2015 | acute surgical | surgery | RCT | 35 | acute pancreatitis | 17 (NTF) | 18(NPO) | Poor | ||||
Bing Li | 2015 | post-surgical | surgery | RCT | 400 | gastrectomy | 200(EEN) | 200 (PN) | Poor | ||||
Taylor | 2016 | critically ill | ICU | RCT | 50 | critically ill | 25 (NJ) | 25(NG + ProK) | Poor | ||||
Ozen | 2016 | critically ill | ICU | RCT | 51 | critically ill | 26(no-GRV's) | 25(GRV's) | Poor | ||||
Van Barneveld | 2016 | elective surgical | surgery | RCT | 123 | rectal ca malignancy | 61 (EEN) | 62(EPN) | Good | ||||
Malik | 2016 | critically ill | ICU | RCT | 60 | critically ill | 30 (EF) | 30 (placebo) | Poor | ||||
Fan | 2016 | critically ill | ICU | RCT | 80 | Severe TBI | 40 (EN) | 40 (PN) | Poor | ||||
Stimac | 2016 | acute pancreatitis | pancreatitis | RCT | 214 | acute pancreatitis | 107 EN | 107 IVF | Poor | ||||
Hongyin | 2017 | acute surgical | surgery | RCT | 161 | acute pancreatitis | 83 (APD)/61 EN) | 78(non-APD)/68(EN) | Poor | ||||
Reigner | 2018 | critically ill | ICU | RCT | 2410 | shock | 1202(EN) | 1208(PN) | Fair |
Author | Year | Study Population | Study | Study | Study | Admission | Experimental | Intravenous | Control | Intravenous | Dindo-Clavien |
---|---|---|---|---|---|---|---|---|---|---|---|
Gan | 2002 | major elective general, urologic, or gynaecologic surgery | surgery | RCT | 100 | postsurgical | 50 | GDFT | 50 | Standard | |
Moretti1 7 | 2003 | Major elective cardiac surgery | surgery | RCT | 90 | postsurgical | 30 - HetaStarch normal saline; 30 Heta Starch Balanced | ||||
Nisanevich | 2005 | elective intraabdominal surgery | surgery | RCT | 157 | postsurgical | 77 | Restrictive | 75 | Liberal | |
Kabon | 2005 | open colonic resection | surgery | RCT | 253 | ICU surgical | 124 | Small volume | 129 | Large Volume | |
Lopes | 2007 | High-risk surgery | surgery | RCT | 33 | ICU surgical | 17 | GDFT | 16 | Control | |
Vermuelen | 2009 | elective major abdominal surgical procedures | surgical | RCT | 62 | surgical | 30 | Restricted | 32 | Standard | |
Mayer | 2010 | major abdominal surgery | surgery | RCT | 60 | ICU surgical | 30 | GDFT | 30 | Standard | |
SAFE | 2011 | ICU | ICU | RCT | 1218 | ICU | 603 | Colloid | 615 | Crystalloid | |
Guidet | 2012 | severe sepsis | ICU | RCT | 196 | ICU | 100 | Colloid | 96 | Crystalloid | |
Perner | 2012 | severe sepsis | ICU | RCT | 798 | ICU | 398 | Colloid | 400 | Crystalloid | |
Reddy | 2016 | critically ill | ICU | RCT | 69 | critically ill | 35 | plasmalyte | 34 | saline |
Grade | Grade Definition |
---|---|
Grade I | Any deviation from the normal postoperative course without the need for pharmacological treatment or surgical, endoscopic, and radiological interventions Allowed therapeutic regimens are: drugs as antiemetics, antipyretics, analgesics, diuretics, electrolytes, and physiotherapy. This grade also includes wound infections opened at the bedside |
Grade II | Requiring pharmacological treatment with drugs other than such allowed for grade I complications, Blood transfusions and total parenteral nutrition are also included |
Grade III | Requiring surgical, endoscopic or radiological intervention Grade IIIa Intervention not under general anaesthesia Grade IIIb Intervention under general anaesthesia |
Grade IV | Life-threatening complication (including CNS complications)* requiring IC/ICU management Grade IVa Single organ dysfunction (including dialysis) Grade IVb Multiorgan dysfunction) |
Author | Year | Study Population | Study | Study | Study | Admission diagnosis | Experimental | Intravenous | Control | Intravenous fluid | Dindo-Clavien | |||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Prein | 1990 | post-surgery | surgery | RCT | 18 | modified Whipple's | 6- ringers' lactate; 6– starch; 6-albumin | I | II | III | IV | |||
Salim | 1991 | elective surgery | surgery | RCT | 130 | Hartmann's procedure +/- cholecystectomy | 71 | early oral | 59 | conventional intravenous | ||||
Yogendran | 1995 | elective surgery | surgical | RCT | 200 | surgical | 100 | Low-infusion | 100 | High infusion | ||||
Wilkes | 2001 | elective, open surgical | surgical | RCT | 47 | surgical | 23 | Balanced | 24 | Saline | ||||
Lobo | 2002 | post-surgery | surgery | RCT | 20 | colorectal surgery | 10 | restricted | 10 | liberal | ||||
Conway | 2002 | major bowel surgery | surgical | RCT | 57 | surgical | 28 | GDFT | 39 | Standard | ||||
Venn | 2002 | hip fracture surgery | surgical | RCT | 90 | surgical | 29CON- VF ; CVP guided FT- 3 1 ; Doppler-guided FT- 30 | |||||||
SAFE | 2004 | ICU | ICU | RCT | 6997 | ICU | 3497 | Colloid | 3500 | Crystalloid | ||||
Parker | 2004 | hip fracture surgery | surgical | RCT | 396 | surgical | 198 | Colloid | 198 | Crystalloid | ||||
Noblett | 2005 | elective colorectal resection | surgical | RCT | 108 | surgical | 54 | GDFT | 54 | Standard | ||||
Wakeling | 2005 | large bowel surgery | surgical | RCT | 128 | surgical | 64 | GDFT | 64 | Standard | ||||
Mackay | 2006 | elective colorectal surgery | surgical | RCT | 80 | surgical | 41 | Restricted | 39 | Standard | ||||
En-quiang | 2009 | critically ill | S-ICU | RCT | 76 | severe acute pancreatitis | 30 | controlled fluid expansion | 30 | rapid fluid expansion | ||||
Senagore | 2009 | laparoscopic | surgical | RCT | 64 | surgical | 21 GDFT/LR; 21 GDFT/HS;2 22 standard | |||||||
Futier | 2010 | major abdominal surgery | surgery | RCT | 70 | postsurgical | 36 | Restricted-GDFT | 34 | Conservative GDFT | ||||
Benes | 2010 | elective intraabdominal | surgery | RCT | 120 | ICU surgical | 60 | GDFT | 60 | Standard | ||||
Pillai | 2011 | post-surgery | surgery | RCT | 66 | radical cystectomy | 34 | intervention | 32 | control | ||||
Du | 2011 | critically ill | ICU | RCT | 41 | severe acute pancreatitis | 20 | starch | 21 | ringers' lactate | ||||
James | 2011 | Blunt and penetrating | surgical | RCT | 109 | surgical | Penetrating trauma- HES 36 ; SAL 31 Blunt trauma- HES20 ; SAL 22 | |||||||
Challand | 2012 | major elective colorectal | surgical | RCT | 179 | surgical | 90 | GDFT | 89 | Standard | ||||
Myberg | 2012 | ICU | ICU | RCT | 7000 | ICU | 3500 | Colloid | 3500 | Crystalloid | ||||
Srinivasa | 2012 | elective colectomy | surgical | RCT | 85 | surgical | 37 | GDFT Restricted | 37 | Restricted | ||||
Zheng | 2013 | post-surgery | surgery | RCT | 60 | gastrointestinal surgery | 30 | GDFT | 30 | control | ||||
Scheeren | 2013 | High-risk surgery | ICU | RCT | 52 | ICU | 26 | GDFT | 26 | Control | ||||
Pestana | 2014 | post-surgery | S-ICU | RCT | 142 | abdominal surgery | 70 | GDFT | 72 | control | ||||
Pearse | 2014 | Major Gastrointestinal | surgery | RCT | 734 | surgical | 368 | GDFT | 366 | Standard | ||||
Peng | 2014 | elective surgery | surgery | RCT | 80 | orthopaedic surgery | 40 | GDFT | 40 | standard | ||||
Reisinger | 2017 | elective colorectal resection | surgery | RCT | 58 | postsurgical | 27 | GDFT | 31 | Standard | ||||
# Searches Results |
---|
1 Gastrointestinal Diseases/ |
2 ((gastrointestinal or intestin* or digestive) adj3 (dysfunction* or failure or disorder* or injur* or disease*)).mp. |
3 ((abdominal or gut or bowel or intestin*) adj3 (perforat* or infarct* or obstruct* or failure or ischemi*)).mp. |
4 gastroparesis.mp. or Gastroparesis/ |
5 gastrointestinal motilit*.mp. or exp Gastrointestinal Motility/ |
6 (dysmotilit* or intestinal motilit*).mp. 5645 |
7 Intra-Abdominal Hypertension/ |
8 (abdominal compartment syndrome* or intra abdominal hypertension or intraabdominal hypertension).mp. |
9 feed* intolerance.mp. |
10 ileus.mp. or Ileus/ |
11 Intestinal Obstruction/ or Intestinal Pseudo-Obstruction/ or pseudo obstruction.mp. or ogilvie’s syndrome.mp. |
12 (mesenteric or peritonitis).mp. 91360 |
13 or/1-12 282880 |
14 enteral nutrition/ or parenteral nutrition/ |
15 Parenteral Nutrition, Total/ |
16 ((enteral or parenteral) adj3 (feed* or nutrition)).mp. |
17 Fluid Therapy/ or intravenous fluid*.mp. |
18 (fluid* adj3 therap*).mp. |
19 (resuscitation adj3 fluid*).mp. |
20 vasoactive.mp. |
21 Vasoconstrictor Agents/ or vasoconstrictor*.mp. or vasopressor*.mp. |
22 inotrope*.mp. |
23 or/14-22 |
24 intensive care/ or critical illness/ |
25 Intensive Care Units/ |
26 General Surgery/ |
27 Postoperative Complications/ or Postoperative Care/ |
28 (intensive care or ICU or critical care or critical* ill*).mp. |
29 (surgery or surgical or postoperative).mp. |
30 or/24-29 |
31 randomized controlled trial.pt. |
32 controlled clinical trial.pt. |
33 randomized.ab. |
34 placebo.ab. 35 drug therapy.fs. |
36 randomly.ab. |
37 trial.ab. 38 groups.ab. |
39 or/31-38 |
40 adult/ or aged/ or “aged, 80 and over”/ or frail elderly/ or middle aged/ or (adult* or middle aged or older or old or aged or |
elderly or geriatric* or frail).mp. |
41 13 and 23 and 30 and 39 and 40 |
42 exp animals/ not humans.sh |
43 41 not 42 |