Clinical Outcomes of Hypocaloric/Hyperproteic vs Normocaloric Enteral Feeding in the Acute Phase of Critical Illness among Patients Admitted in the Intensive Care Unit: A Systematic Review with Meta-analysis.

Abstract

Objectives: To examine the effect of hypocaloric/hyperproteic enteral feeding vs normocaloric feeding on the survival of critically ill patients in the acute phase in the intensive care unit (ICU).

Methodology: Randomized clinical trials utilizing hypocaloric, hyperproteic, and normocaloric enteral feeding in the ICU were searched using the following terms ((((critically ill) OR (intensive care) OR (mechanically ventilated)) AND ((low-calorie enteral feeding) OR (high-protein enteral feeding)))) in MEDLINE, PubMed, Scopus, and Google Scholar by two independent authors.

Results: There were no significant differences in hospital mortality [odds ratio (OR), 1.0; 95% confidence interval (CI), 0.77, 1.31; p = 0.99, I ² = 0%], days on mechanical ventilation (MD, -0.05; 95% CI, -0.37, 0.28; p = 0.78, I ² = 0%), the odds of acquiring infectious complications (OR, 0.90; 95% CI, 0.71, 1.14; p = 0.38, I ² = 0%), and the length of ICU stay (MD, 0.60; 95% CI, -2.39, 3.59; p = 0.69, I ² = 96%). The length of hospital stay was significantly lower by 4.18 days in the normocaloric group (MD, 4.18; 95% CI, 2.50, 5.85; p < 0.00001, I ² = 0%).

Conclusion: This meta-analysis showed no significant differences in mortality, infectious complications, days of mechanical ventilation, and ICU length of stay between groups. Findings on hospital length of stay were interpreted with caution due to the low quality of evidence and clinical heterogeneity.

How to cite this article: Permejo CC, Evangelista TJP. Clinical Outcomes of Hypocaloric/Hyperproteic vs Normocaloric Enteral Feeding in the Acute Phase of Critical Illness among Patients Admitted in the Intensive Care Unit: A Systematic Review with Meta-analysis. Indian J Crit Care Med 2024;28(11):1069-1083.