<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec id="j_jccm-2021-0011_s_006">
<h3>Objectives</h3>
<p>This systematic review aims to evaluate and summarise the findings of all relevant studies which identified the effect of early vs delayed parenteral nutrition (PN), early PN vs early supplemental PN and early PN vs standard care for critically ill adults.</p>
</sec>
<sec id="j_jccm-2021-0011_s_007">
<h3>Methods</h3>
<p>The literature search was undertaken using PubMed, Embase, Medline, Clinical Key, and Ovid discovery databases. The reference lists of studies published from 2000 till June 2020 were hand searched.</p>
</sec>
<sec id="j_jccm-2021-0011_s_008">
<h3>Result</h3>
<p>On screening 2088 articles, a total of five RCTs with 6,277 patients were included in this review. Only one clinical trial compared early PN and late PN; the results reported significantly shorter periods in intensive care unit (ICU) stay (p=0.02) and less ICU related infections (p=0.008) in the late PN group compared to the Early PN group. Two trials compared total parenteral nutrition (TPN) and enteral nutrition (EN) +TPN groups. Both found a significantly longer hospital stay duration (p&lt;0.05 and p&lt;0.01) with a higher mortality rate in the TPN group compared to the EN+TPN group. A statistically significant improvement was observed in patients’ quality of life receiving early PN compared to standard care (p=0.01). In contrast, no significant difference was found in the supplemental PN vs the standard care group.</p>
</sec>
<sec id="j_jccm-2021-0011_s_009">
<h3>Conclusion</h3>
<p>The supplemental PN patients had shorter ICU stay and lower mortality rates than TPN. However, these findings should be interpreted carefully as included studies have different initiation timing of nutritional support, and the patients’ diagnosis varied.</p>
</sec>
</abstract>

Objectives
This systematic review aims to evaluate and summarise the findings of all relevant studies which identified the effect of early vs delayed parenteral nutrition (PN), early PN vs early supplemental PN and early PN vs standard care for critically ill adults.


Methods
The literature search was undertaken using PubMed, Embase, Medline, Clinical Key, and Ovid discovery databases. The reference lists of studies published from 2000 till June 2020 were hand searched.


Result
On screening 2088 articles, a total of five RCTs with 6,277 patients were included in this review. Only one clinical trial compared early PN and late PN; the results reported significantly shorter periods in intensive care unit (ICU) stay (p=0.02) and less ICU related infections (p=0.008) in the late PN group compared to the Early PN group. Two trials compared total parenteral nutrition (TPN) and enteral nutrition (EN) +TPN groups. Both found a significantly longer hospital stay duration (p<0.05 and p<0.01) with a higher mortality rate in the TPN group compared to the EN+TPN group. A statistically significant improvement was observed in patients’ quality of life receiving early PN compared to standard care (p=0.01). In contrast, no significant difference was found in the supplemental PN vs the standard care group.


Conclusion
The supplemental PN patients had shorter ICU stay and lower mortality rates than TPN. However, these findings should be interpreted carefully as included studies have different initiation timing of nutritional support, and the patients’ diagnosis varied.

Effect of Early versus Delayed Parenteral Nutrition on the Health Outcomes of Critically Ill Adults: A Systematic Review

The Journal of Critical Care Medicine

This work is licensed under the Creative Commons Attribution 4.0 International License.

Objectives
This systematic review aims to evaluate and summarise the findings of all relevant studies which identified the effect of early vs delayed...

Effect of Early versus Delayed Parenteral Nutrition on the Health Outcomes of Critically Ill Adults: A Systematic Review

Article Category: Review

Published Online: Aug 05, 2021

Page range: 160 - 169

Received: Oct 11, 2020

Accepted: Mar 11, 2021

DOI: https://doi.org/10.2478/jccm-2021-0011

Keywords
early parenteral nutrition, delayed parenteral nutrition

© 2021 Suresh Kumar Sharma, Ritu Rani, Kalpana Thakur, published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Effect of Early versus Delayed Parenteral Nutrition on the Health Outcomes of Critically Ill Adults: A Systematic Review

Article Category: Review

Published Online: Aug 05, 2021

Page range: 160 - 169

Received: Oct 11, 2020

Accepted: Mar 11, 2021

DOI: https://doi.org/10.2478/jccm-2021-0011

Keywordsearly parenteral nutrition, delayed parenteral nutrition

© 2021 Suresh Kumar Sharma, Ritu Rani, Kalpana Thakur, published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Keywords
early parenteral nutrition, delayed parenteral nutrition