Protocol for a systematic review and meta-analysis investigating the impact of continuous versus intermittent enteral feeding in critically ill patients

IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Lydia S. Acharya, Anne M. Clayton, Lawrence Mbuagbaw, Simon Oczkowski, Bram Rochwerg, Jennifer Tsang, Kaitryn Campbell, Karin Dearness, Joanna C. Dionne
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引用次数: 0

Abstract

Enteral nutrition (EN) is the recommended nutritional support in most critically ill populations. When given by feeding tube, EN may be administered either continuously or intermittently. It is unclear which approach is superior in reducing gastrointestinal complications—such as diarrhea—and meeting nutritional targets. The main objectives of this systematic review and meta-analysis are to (1) determine whether continuous or intermittent enteral nutrition is associated with higher incidence of adverse gastrointestinal outcomes, including diarrhea, and (2) determine which feeding modality is associated with reaching nutritional goals. This systematic review protocol is reported in accordance with guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement. We will search MEDLINE, Embase, the Cochrane Library, and the World Health Organization (WHO) International Clinical Trials Registry (ICTRP) search portal for studies comparing continuous EN and intermittent EN in critically ill patients with no date or language restrictions. Studies will be screened, selected, and extracted independently and in duplicate. We will assess the risk-of-bias assessment using the Cochrane Collaboration’s Risk of Bias (RoB) 2 tool. The primary outcome will include the incidence of diarrhea; secondary outcomes include other adverse GI outcomes (nausea, vomiting, abdominal pain, and constipation), as well as reaching nutritional goals, and length of ICU and hospital stay and mortality. We will pool data using a random-effects model and assess the certainty of the evidence for each outcome using Grading of Recommendations, Assessment, Development and Evaluations (GRADE) methodology. Ethics approval is not required for this study as no original data will be collected. We will disseminate results through peer-reviewed publication and conference presentations. PROSPERO CRD42022330118.
系统综述和荟萃分析规程:调查持续性和间歇性肠内喂养对重症患者的影响
肠内营养(EN)是大多数重症患者推荐的营养支持方式。通过输液管给药时,肠内营养可持续或间歇给药。目前还不清楚哪种方法在减少腹泻等胃肠道并发症和达到营养目标方面更具优势。本系统综述和荟萃分析的主要目的是:(1) 确定持续性或间歇性肠内营养是否与较高的胃肠道不良反应(包括腹泻)发生率相关;(2) 确定哪种喂养方式与达到营养目标相关。本系统综述方案根据《系统综述和元分析方案首选报告项目》(PRISMA-P)声明的指导原则进行报告。我们将搜索 MEDLINE、Embase、Cochrane 图书馆和世界卫生组织 (WHO) 国际临床试验注册中心 (ICTRP) 的搜索门户,以查找在重症患者中比较持续性营养补充剂和间歇性营养补充剂的研究,没有日期或语言限制。我们将对研究进行独立筛选、选择和提取,并一式两份。我们将使用 Cochrane 协作组织的偏倚风险 (RoB) 2 工具对偏倚风险进行评估。主要结果包括腹泻发生率;次要结果包括其他消化道不良结果(恶心、呕吐、腹痛和便秘)、营养目标达成情况、重症监护室和住院时间以及死亡率。我们将使用随机效应模型汇集数据,并使用建议、评估、发展和评价分级(GRADE)方法评估每项结果的证据确定性。由于本研究无需收集原始数据,因此无需获得伦理批准。我们将通过同行评议出版物和会议演讲传播研究结果。PERCOMO CRD42022330118.
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来源期刊
Systematic Reviews
Systematic Reviews Medicine-Medicine (miscellaneous)
CiteScore
8.30
自引率
0.00%
发文量
241
审稿时长
11 weeks
期刊介绍: Systematic Reviews encompasses all aspects of the design, conduct and reporting of systematic reviews. The journal publishes high quality systematic review products including systematic review protocols, systematic reviews related to a very broad definition of health, rapid reviews, updates of already completed systematic reviews, and methods research related to the science of systematic reviews, such as decision modelling. At this time Systematic Reviews does not accept reviews of in vitro studies. The journal also aims to ensure that the results of all well-conducted systematic reviews are published, regardless of their outcome.
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