Clinical nutrition ESPEN · 2025
Use of pectin-supplemented enteral nutrition in intensive care: A systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Huang Hui-Bin, Zhu Yi-Bing, Yu Da-Xing
Аннотация
BACKGROUND: Pectin is a water-soluble dietary fiber that has been widely used in hospitalized patients. However, there is insufficient high-quality evidence to support its use in critically ill patients. Therefore, we aimed to conduct a systematic review and meta-analysis to evaluate the efficacy and safety of pectin-supplemented enteral nutrition (PSEN) on diarrhea and other important outcomes in this patient population.
METHODS: We searched PubMed, Embase, China National Knowledge Infrastructure, Wanfang, and the Cochrane database for relevant articles from inception to Oct 15, 2023. Studies were included if they focused on adult ICU patients receiving PSEN compared to controls. The primary outcome was diarrhea. We assessed study quality and performed subgroup analysis, sensitivity analysis, GRADE system and trial sequential analysis (TSA) to explore potential heterogeneity among the included studies.
RESULTS: Twelve trials with 1,405 patients were included. Overall, PSEN significantly reduced the risk of diarrhea (odds ratio [OR] = 0.40; 95 % CI, 0.30-0.54; P < 0.00001). This finding was confirmed in further subgroup and sensitivity analyses. Of note, PSEN significantly reduced the risk of diarrhea in patients who did not use PPIs but not in those who did. PSEN also significantly reduced infectious complications (OR = 0.43; 95 % CI, 0.26-0.70; P = 0.0007), ICU length of stay (MD = -3.59 days; 95 % CI, -7.13 to -0.05; P = 0.05), and hospital length of stay (MD = -6.79 days; 95 % CI, -10.24 to -3.34; P = 0.0001). In addition, PSEN significantly reduced intestinal intolerance symptoms (vomiting [OR = 0.27; 95 % CI, 0.15-0.48], feeding intolerance [OR = 0.39; 95 % CI, 0.22-0.68], abdominal distension [OR = 0.22; 95 % CI, 0.22-0.46] and severe constipation [OR = 0.20; 95 % CI, 0.12-0.35]) and nutrition status (shorter time to target EN amount [MD = -1.81 days; 95 % CI, -2.18 to -1.44] and prealbumin changes [MD = -1.81 days; 95 % CI, -2.18 to -1.44]) but did not affect mortality (OR = 0.86; 95 % CI, 0.56-1.33) in this patient population. TSA and sensitivity analyses confirmed the primary findings.
CONCLUSIONS: PSEN significantly had better feeding intolerance, and improved important clinical outcomes. Further studies with better PSEN protocol are required to validate our findings.
METHODS: We searched PubMed, Embase, China National Knowledge Infrastructure, Wanfang, and the Cochrane database for relevant articles from inception to Oct 15, 2023. Studies were included if they focused on adult ICU patients receiving PSEN compared to controls. The primary outcome was diarrhea. We assessed study quality and performed subgroup analysis, sensitivity analysis, GRADE system and trial sequential analysis (TSA) to explore potential heterogeneity among the included studies.
RESULTS: Twelve trials with 1,405 patients were included. Overall, PSEN significantly reduced the risk of diarrhea (odds ratio [OR] = 0.40; 95 % CI, 0.30-0.54; P < 0.00001). This finding was confirmed in further subgroup and sensitivity analyses. Of note, PSEN significantly reduced the risk of diarrhea in patients who did not use PPIs but not in those who did. PSEN also significantly reduced infectious complications (OR = 0.43; 95 % CI, 0.26-0.70; P = 0.0007), ICU length of stay (MD = -3.59 days; 95 % CI, -7.13 to -0.05; P = 0.05), and hospital length of stay (MD = -6.79 days; 95 % CI, -10.24 to -3.34; P = 0.0001). In addition, PSEN significantly reduced intestinal intolerance symptoms (vomiting [OR = 0.27; 95 % CI, 0.15-0.48], feeding intolerance [OR = 0.39; 95 % CI, 0.22-0.68], abdominal distension [OR = 0.22; 95 % CI, 0.22-0.46] and severe constipation [OR = 0.20; 95 % CI, 0.12-0.35]) and nutrition status (shorter time to target EN amount [MD = -1.81 days; 95 % CI, -2.18 to -1.44] and prealbumin changes [MD = -1.81 days; 95 % CI, -2.18 to -1.44]) but did not affect mortality (OR = 0.86; 95 % CI, 0.56-1.33) in this patient population. TSA and sensitivity analyses confirmed the primary findings.
CONCLUSIONS: PSEN significantly had better feeding intolerance, and improved important clinical outcomes. Further studies with better PSEN protocol are required to validate our findings.