Cochrane · systematic review · CD012340
Early enteral nutrition (within 48 hours) versus delayed enteral nutrition (after 48 hours) with or without supplemental parenteral nutrition in critically ill adults
Fuentes Padilla, P, Martínez, G, Vernooij, RWM, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
Emergency and Critical CareAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
12
current version
GRADE rated
9
No studies
3
Included studies
NR
No studies 3 · 25%Ungraded 0 · 0%Very low 9 · 75%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Early enteral nutrition compared to delayed enteral nutrition for critically ill adults
Population: critically ill adults
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality (measured at 30 days) Early enteral nutrition vs delayed enteral nutrition | RR 1 [0.16, 6.38] | 1 study · 38 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Infectious complications (independent of specific site, as defined by the trial authors) ( Early enteral nutrition vs delayed enteral nutrition | no estimate extracted | 3 studies · 156 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Feed intolerance or gastrointestinal complications (as defined by the trial authors, vomiting, diarrhoea, high gastric residual volume, or gastrointestinal bleeding) ( Early enteral nutrition vs delayed enteral nutrition | RR 0.84 [0.35, 2.01] | 1 study · 59 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Hospital length of stay (measured in days) Early enteral nutrition vs delayed enteral nutrition | no estimate extracted | 1 study · 59 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Duration of mechanical ventilation (measured in days) ( Early enteral nutrition vs delayed enteral nutrition | no estimate extracted | 3 studies · 125 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Pneumonia (as defined by the authors) ( Early enteral nutrition vs delayed enteral nutrition | RR 0.77 [0.55, 1.06] | 4 studies · 192 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Early enteral nutrition with supplemental parenteral nutrition (SPN) compared to delayed enteral nutrition with SPN for critically ill adults
Population: critically ill adults
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality (timing of outcome measurement unclear) Early enteral nutrition with supplemental parenteral nutrition (SPN) vs delayed enteral nutrition with SPN | RR 0.74 [0.25, 2.18] | 1 study · 27 participants | Very low Downgraded: imprecision, indirectness |
Infectious complications (independent of specific site, as defined by the trial authors) ( Early enteral nutrition with supplemental parenteral nutrition (SPN) vs delayed enteral nutrition with SPN | no estimate extracted | 1 study · 27 participants | Very low Downgraded: imprecision, indirectness |
Feed intolerance or gastrointestinal complications (as defined by the authors) Early enteral nutrition with supplemental parenteral nutrition (SPN) vs delayed enteral nutrition with SPN | no estimate extracted | NR | No studies |
Hospital length of stay (measured in days) Early enteral nutrition with supplemental parenteral nutrition (SPN) vs delayed enteral nutrition with SPN | no estimate extracted | NR | No studies |
Duration of mechanical ventilation (measured in days) ( Early enteral nutrition with supplemental parenteral nutrition (SPN) vs delayed enteral nutrition with SPN | no estimate extracted | 1 study · 27 participants | Very low Downgraded: imprecision, indirectness |
Pneumonia (as defined by the authors) ( Early enteral nutrition with supplemental parenteral nutrition (SPN) vs delayed enteral nutrition with SPN | no estimate extracted | NR | No studies |