• X Zhou, H Fang, C Hu, J Xu, H Wang, J Pan, Y Sha, and Z Xu.
• Department of Intensive Care Medicine, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang 315000, China.
• Med Intensiva. 2021 May 1; 45 (4): 211-225.

ObjectivesTo compare the effect of hypocaloric versus standard enteral feeding on clinical outcomes in critically ill adults, and to investigate the influence of protein intake upon the outcome effects of hypocaloric feeding.DesignA meta-analysis of randomized controlled trials (RCTs) and trial sequential analysis (TSA) were carried out.SettingIntensive Care Unit (ICU).PatientsOr participants Critically ill adults.InterventionsHypocaloric enteral feeding versus standard enteral feeding.Main Variables Of InterestThe primary outcomes were all-cause short-term mortality and the incidence of nosocomial infection.ResultsEleven RCTs met the inclusion criteria; of these trials, two were judged as having low risk of bias. Compared with standard enteral feeding, hypocaloric enteral feeding had no benefits in terms of reducing short-term mortality, the incidence of nosocomial infection, or long-term mortality, though it had a positive impact upon the incidence of gastrointestinal intolerance. The TSA further confirmed these results. In turn, hypocaloric enteral feeding had no effects upon the incidence of bloodstream infection, pneumonia, hypoglycemia or the duration of mechanical ventilation, ICU stay, or in-hospital stay. The above results remained unchanged in the sub-analysis of trials with a low risk of bias, trials administering a similar dose of protein, or trials administering different doses of protein.ConclusionsCompared with standard enteral feeding, hypocaloric enteral feeding was not associated with better clinical outcomes in critically ill adults, except for a lower risk of gastrointestinal intolerance. The difference in protein intake between groups might have no influence on the outcome effects of hypocaloric enteral feeding. High quality randomized controlled trials are needed to confirm this, however.Copyright © 2019 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

10 keywords...

hide…