Ni Yang, Yuan Xu, Xinyi Zhou, Shuli Guo, Haibo Deng, Jianhua Sun, Ying Liu, Manna Shao, Yufen Ma
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引用次数: 0
Abstract
Background: Enteral nutrition is beneficial for improving the clinical outcomes of intensive care unit patients. However, enteral nutrition intolerance is a common complication in intensive care unit patients undergoing enteral nutrition.
Aims: We aimed to assess the effectiveness of non-pharmacological interventions in preventing enteral nutrition intolerance in intensive care unit patients and to identify the optimal non-pharmacological interventions.
Study design: Seven databases were searched to obtain randomized controlled trials involving non-pharmacological interventions to prevent enteral nutrition intolerance in intensive care unit patients. Network meta-analysis was performed using Stata18.0 software, and the integrated data were investigated with odds ratio (OR) and 95% confidence interval (95% CI).
Results: A total of 16 randomized controlled trials involving 10 non-pharmacological interventions and 1765 intensive care unit patients were included. Compared with routine enteral nutrition care, network meta-analysis showed that bundled care [OR = 0.93, 95% CI (0.32-1.53)] (p = .003), intra-abdominal pressure monitoring [OR = 1.68, 95%CI (1.19-2.16)] (p < .001), acupuncture [OR = 2.69, 95%CI (1.64-3.73)] (p < .001), pectin-added intermittent enteral nutrition [OR = 1.13, 95%CI (0.48-1.77)] (p = .001), multidisciplinary nutritional treatment model [OR = 1.98, 95%CI (0.87-3.10)] (p < .001), abdominal massage [OR = 2.42, 95%CI (1.50-3.34)] (p < .001) and intermittent feeding with semisolid nutrients [OR = 2.08, 95%CI (0.19-3.97)] (p = .031) were effective in preventing enteral nutrition intolerance in intensive care unit patients. The ranking probabilities of the interventions indicated that acupuncture (89.4%) was the optimal non-pharmacological intervention for preventing enteral nutrition intolerance in intensive care unit patients, followed by abdominal massage (83.4%).
Conclusions: Acupuncture and abdominal massage are recommended to prevent enteral nutrition intolerance in intensive care unit patients. Moreover, more high-quality trials are needed to investigate the reliability of evidence levels for different non-pharmacological interventions.
Relevance to clinical practice: This study provided evidence for intensive care nurses that acupuncture is the optimal intervention to improve enteral nutrition intolerance in intensive care unit patients among the 10 interventions. However, unique clinical circumstances should be considered. Therefore, we recommend that intensive care nurses also use abdominal massage when acupuncture is not available.
期刊介绍：
Nursing in Critical Care is an international peer-reviewed journal covering any aspect of critical care nursing practice, research, education or management. Critical care nursing is defined as the whole spectrum of skills, knowledge and attitudes utilised by practitioners in any setting where adults or children, and their families, are experiencing acute and critical illness. Such settings encompass general and specialist hospitals, and the community. Nursing in Critical Care covers the diverse specialities of critical care nursing including surgery, medicine, cardiac, renal, neurosciences, haematology, obstetrics, accident and emergency, neonatal nursing and paediatrics.
Papers published in the journal normally fall into one of the following categories:
-research reports
-literature reviews
-developments in practice, education or management
-reflections on practice
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