Effects of gastric residual volume set at different thresholds on intensive care patients receiving enteral nutrition: a systematic review

Q4 Nursing

中华临床营养杂志 Pub Date : 2018-02-28 DOI:10.3760/CMA.J.ISSN.1674-635X.2018.01.002

Song Zhou, Jianning Wang, Mengmei Zhan, Qiuxia Huang

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引用次数: 0

Abstract

Objective To compare the effects of gastric residual volume (GRV) set at different thresholds on intensive care patients receiving enteral nutrition (EN), so as to inform clinical practice. Methods Controlled clinical trials involving different GRV thresholds in ICU patients undergoing EN were retrieved from multiple electronic databases (including Cochrane Library, PubMed, Ovid Medline, Web of Science, CBM, CNKI, Wanfang Data, and VIP). Quality of the retrieved studies was evaluated for data extraction, and meta-analysis was performed. Results Four randomized controlled trials and one clinically controlled trial were included in the study, with a total of 658 subjects. Results of the meta-analysis suggested no statistically significant difference between the group with GRV threshold≥250 ml and the one with GRV threshold<250 ml in the rates of pneumonia (OR=1.19, 95% CI=0.77-1.82, P=0.43), aspiration (OR=1.59, 95% CI=0.42-6.03, P=0.50), vomiting (OR=1.35, 95% CI=0.48-3.80, P=0.57), reflux (OR=1.29, 95% CI=0.58-2.88, P=0.53), and diarrhea (OR=1.36, 95% CI=0.87-2.13, P=0.17). Nutrient intake and several other outcome measures were unable to be included in the meta-analysis for either the scarcity of studies or inconsistency in the measures adopted, and descriptive analysis was therefore employed instead. Conclusion There was no significant difference between the two groups in terms of complications, but the group with GRV threshold≥250 ml had higher intake of EN. Key words: Enteral nutrition; Intensive care units; Meta-analysis; Gastric residual volume; Complications

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不同阈值胃剩余容量对重症监护患者肠内营养的影响:一项系统综述

目的比较不同阈值设置胃残留量(GRV)对重症监护患者肠内营养(EN)的影响，为临床提供参考。方法从多个电子数据库(Cochrane Library、PubMed、Ovid Medline、Web of Science、CBM、CNKI、万方数据、VIP)中检索不同GRV阈值的ICU EN患者对照临床试验。对所检索研究的质量进行评估以提取数据，并进行meta分析。结果纳入4项随机对照试验和1项临床对照试验，共纳入658名受试者。meta分析结果显示，GRV阈值≥250 ml组与GRV阈值<250 ml组在肺炎(OR=1.19, 95% CI=0.77 ~ 1.82, P=0.43)、误吸(OR=1.59, 95% CI=0.42 ~ 6.03, P=0.50)、呕吐(OR=1.35, 95% CI=0.48 ~ 3.80, P=0.57)、反流(OR=1.29, 95% CI=0.58 ~ 2.88, P=0.53)、腹泻(OR=1.36, 95% CI=0.87 ~ 2.13, P=0.17)发生率方面无统计学差异。由于缺乏研究或采用的测量方法不一致，营养素摄入量和其他几个结果测量无法纳入meta分析，因此采用描述性分析。结论两组患者并发症发生率无显著差异，但GRV阈值≥250 ml组EN摄取量较高。关键词:肠内营养;重症监护病房;荟萃分析;胃残量;并发症

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来源期刊

中华临床营养杂志 Nursing-Nutrition and Dietetics

CiteScore

0.20

自引率

0.00%

发文量

2282

期刊介绍： The Chinese Journal of Clinical Nutrition was founded in 1993. It is the first professional academic journal (bimonthly) in my country co-sponsored by the Chinese Medical Association and the Chinese Academy of Medical Sciences to disseminate information on clinical nutrition support, nutrient metabolism, the impact of nutrition support on outcomes and "cost-effectiveness", as well as translational medicine and nutrition research. It is also a professional journal of the Chinese Medical Association's Parenteral and Enteral Nutrition Branch. The purpose of the Chinese Journal of Clinical Nutrition is to promote the rapid dissemination of knowledge on nutrient metabolism and the rational application of parenteral and enteral nutrition, focusing on the combination of multidisciplinary and multi-regional field investigations and clinical research. It mainly reports on nutritional risk screening related to the indications of parenteral and enteral nutrition support, "cost-effectiveness" research on nutritional drugs, consensus on clinical nutrition, guidelines, expert reviews, randomized controlled studies, cohort studies, glycoprotein and other nutrient metabolism research, systematic evaluation of clinical research, evidence-based case reports, special reviews, case reports and clinical experience exchanges, etc., and has a special column on new technologies related to the field of clinical nutrition and their clinical applications.