Evaluating the Safety and Efficacy of Intraoperative Enteral Nutrition in Critically Ill Burn Patients: A Systematic Review and Meta-analysis.
Journal
Journal of burn care & research : official publication of the American Burn Association
ISSN: 1559-0488
Titre abrégé: J Burn Care Res
Pays: England
ID NLM: 101262774
Informations de publication
Date de publication:
03 07 2020
03 07 2020
Historique:
pubmed:
10
3
2020
medline:
6
10
2021
entrez:
10
3
2020
Statut:
ppublish
Résumé
Major burn injuries incite a hypermetabolic response, and the initiation of early enteral nutrition is the standard of care in patients with large burns and contributes to improved outcomes. Perioperative fasting is a common cause of caloric deficits in burn patients and can be obviated with intraoperative enteral nutrition. However, the risks and benefits of this practice are unknown, and there is a concern for aspiration. We conducted a systematic review and meta-analysis to evaluate the safety and efficacy of intraoperative enteral nutrition. We performed a systematic literature search using PubMed, Scopus, and OvidSP MEDLINE databases. We identified studies that evaluated the effects of intraoperative enteral nutrition in adult burn patients compared to those undergoing routine perioperative fasting. We performed a meta-analysis on the incidence of mortality, pneumonia, wound infections, and aspiration in burn patients receiving intraoperative enteral nutrition. We identified seven articles for qualitative review and four for quantitative review (N = 83 patients). There were no statistically significant increases in the risk of mortality (odds ratio [OR] = 1.28, 95% confidence interval [CI]: 0.49, 3.31), wound infections (OR = 0.71, 95% CI: 0.16, 3.24), pneumonia (OR = 2.1, 95% CI: 0.7, 6.1), and aspiration (OR = 1.14, 95% CI: 0.07, 18.75) in patients receiving intraoperative enteral nutrition. Within individual studies, intraoperative enteral nutrition patients received significantly more calories than standard fasting patients. Intraoperative enteral nutrition may increase nutritional intake in burn patients without an increase in complications; however, this is based on limited studies. Randomized controlled trials are needed before recommendations on intraoperative enteral nutrition practice can be made.
Identifiants
pubmed: 32147686
pii: 5799326
doi: 10.1093/jbcr/iraa036
pmc: PMC7333674
doi:
Types de publication
Journal Article
Meta-Analysis
Research Support, N.I.H., Extramural
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
841-848Subventions
Organisme : NHLBI NIH HHS
ID : T32 HL007567
Pays : United States
Informations de copyright
Published by Oxford University Press on behalf of the American Burn Association 2020.
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