Feeding Intolerance in Critically Ill Patients with Enteral Nutrition: A Meta-Analysis and Systematic Review
, , , oraz | 30 sty 2024
O artykule
Article Category: Review
Data publikacji: 30 sty 2024
Zakres stron: 7 - 15
Otrzymano: 05 wrz 2023
Przyjęty: 18 gru 2023
DOI: https://doi.org/10.2478/jccm-2024-0007
Słowa kluczowe
© 2024 Jing Xu et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Fig. 1.
Egger’s test results for detecting publication bias of included studies
| Age < 2 years old | 1.88 | 0.209 |
| Age > 60 years old | 2.47 | 0.113 |
| APACHE II score ≥ 20 | 1.14 | 0.265 |
| Hyperglycemia | −1.32 | 0.179 |
| Hypokalemia | 5.30 | 0.013 |
| Hypoproteinemia | −0.56 | 0.612 |
| Starting time of enteral nutrition > 72 hours | −1.88 | 0.312 |
| No dietary fiber | 1.89 | 0.131 |
| Intra-abdominal pressure > 15mmhg | 1.18 | 0.965 |
| Central venous pressure > 10cmh2o | 3.54 | 0.971 |
| Mechanical ventilation | 2.08 | 0.331 |
| Use of sedatives | −0.22 | 0.832 |
| Use of vasoactive drugs | −0.14 | 0.910 |
| Use of acidogenic agents | 10.58 | 0.060 |
| Blood purification | −0.16 | 0.572 |
The characteristics of included studies
| Bejarano 2012 | Cohort study | 82 | 21/51 | 29.17% | 2, 6, 12 |
| Chen 2017 | Case control study | 92 | 54/38 | 58.69% | 2, 4, 6, 7, 8, 9, 11, 12, 13 |
| Cai 2018 | Case control study | 373 | 155/218 | 41.55% | 1, 3, 7, 8, 10, 12, 13, 14 |
| Sun 2018 | Case control study | 295 | 121/174 | 41.02% | 3, 6, 9, 10, 12, 15, 16 |
| Liu 2018 | Case control study | 86 | 52/34 | 60.47% | 3, 4, 5, 7, 10, 13 |
| Jin 2018 | Case control study | 243 | 84/159 | 34.57% | 1, 3, 6, 7, 8, 9, 10, 11, 12, 13, 15 |
| Wang 2019 | Case control study | 118 | 49/69 | 41.53% | 3, 4, 5, 9, 11 |
| Zhou 2019 | Case control study | 84 | 33/51 | 39.29% | 3, 4, 6, 9, 11, 13, 16 |
| Liu 2020 | Case control study | 200 | 115/85 | 57.50% | 1, 7, 9, 10 |
| Deng 2020 | Case control study | 120 | 68/52 | 56.67% | 3, 12, 13 |
| Zhai 2020 | Case control study | 91 | 49/42 | 53.85% | 3, 4, 5, 6, 9, 10, 12, 13, 14 |
| Li 2019 | Case control study | 568 | 184/384 | 32.39% | 3, 6, 16 |
| Mentec 2001 | Cohort study | 153 | 59/94 | 38.56% | 3, 4, 5, 13, 15 |
| Gungabissoon 2014 | Cohort study | 1888 | 576/1312 | 30.51% | 4, 6, 9 |
| Li 2021 | Case control study | 70 | 29/41 | 41.43% | 1, 4, 5, 6, 10 |
| Geng 2022 | Case control study | 884 | 352/532 | 39.82% | 1, 6, 7, 9, 12 |
| Zhang 2022 | Cohort study | 83 | 36/47 | 43.37% | 2, 4, 5, 8, 10, 13 |
| Zheng 2021 | Case control study | 134 | 56/78 | 41.79% | 2, 5, 7, 9 |
The meta-analysis on the risk factors of feeding intolerance in critically ill patients undergoing enteral nutrition
| I2(%) | P | OR | 95%CI | P | |||
| Age < 2 years old | 2 | 16 | 0.44 | Fixed | 1.84 | 1.32~2.05 | 0.015 |
| Age > 60 years old | 4 | 0 | 0.75 | Fixed | 2.04 | 1.45~2.61 | 0.007 |
| APACHE II score ≥ 20 | 6 | 11 | 0.18 | Fixed | 3.18 | 2.95~3.89 | 0.033 |
| Hyperglycemia | 4 | 59 | 0.03 | Random | 1.70 | 0.88~2.46 | 0.069 |
| Hypokalemia | 5 | 47 | 0.11 | Fixed | 1.59 | 1.24~2.03 | <0.001 |
| Hypoproteinemia | 5 | 89 | <0.01 | Random | 0.70 | 0.26~1.90 | 0.486 |
| Starting time of enteral nutrition > 72 hours | 3 | 0 | 0.87 | Fixed | 2.24 | 1.49~3.36 | <0.001 |
| No dietary fiber | 8 | 68 | 0.01 | Random | 3.72 | 2.23~6.19 | <0.001 |
| Intra-abdominal pressure > 15mmhg | 7 | 0 | 0.51 | Fixed | 2.95 | 2.10~3.85 | <0.001 |
| Central venous pressure > 10cmh2o | 4 | 45 | 0.15 | Fixed | 1.96 | 1.47~2.62 | <0.001 |
| Mechanical ventilation | 9 | 44 | 0.23 | Fixed | 1.37 | 1.19~1.89 | 0.012 |
| Use of sedatives | 7 | 74 | <0.01 | Random | 1.19 | 0.93~1.53 | 0.161 |
| Use of vasoactive drugs | 3 | 89 | <0.01 | Random | 0.95 | 0.56~1.61 | 0.854 |
| Use of acidogenic agents | 3 | 0 | 0.41 | Fixed | 0.84 | 0.52~1.38 | 0.506 |
| Blood purification | 4 | 97 | <0.01 | Random | 1.41 | 0.86~2.30 | 0.171 |
The NOS score of included studies
| Bejarano 2012 | 3 | 2 | 2 | 7 |
| Chen 2017 | 3 | 2 | 2 | 7 |
| Cai 2018 | 3 | 2 | 2 | 7 |
| Sun 2018 | 3 | 2 | 3 | 8 |
| Liu 2018 | 3 | 2 | 2 | 7 |
| Jin 2018 | 3 | 2 | 2 | 7 |
| Wang 2019 | 3 | 2 | 3 | 8 |
| Zhou 2019 | 3 | 2 | 2 | 7 |
| Liu 2020 | 3 | 2 | 2 | 7 |
| Deng 2020 | 3 | 1 | 3 | 7 |
| Zhai 2020 | 3 | 2 | 2 | 7 |
| Li 2019 | 3 | 2 | 3 | 8 |
| Mentec 2001 | 3 | 2 | 2 | 7 |
| Gungabissoon 2014 | 3 | 2 | 2 | 7 |
| Li 2021 | 3 | 2 | 3 | 8 |
| Geng 2022 | 3 | 2 | 3 | 8 |
| Zhang 2022 | 3 | 2 | 3 | 8 |
| Zheng 2021 | 3 | 2 | 2 | 7 |