Which nutrition support is best for ICU patients?

The different types of nutrition support have varying effect on the nutritional status and clinical outcomes of critically ill patients in the intensive care unit (ICU), reports a study. However, parenteral nutrition (PN) combined with enteral nutrition (EN) appears to be most effective in improving clinical outcomes and nutrition support in these patients.

A group of researchers accessed the databases of PubMed, Embase, Cochrane, and Web of Science up to 23 November 2023 for randomized controlled trials, case-control studies, and cohort studies. Outcomes included serum albumin values, length of hospitalization, infection rates, feeding-related complication rates, and mortality.

Twenty-six studies met the eligibility criteria, involving a total of 7,698 critically ill ICU patients receiving four different types of nutrition support, namely PN, EN, enteral immunonutrition (EIN), and PN plus EN.

Results of the network meta-analysis revealed that PN plus EN demonstrated the highest probability of being the most effective intervention for the improvement of serum albumin values (SUCRA, 84.5 percent) and reduction of infection (SUCRA, 83.0 percent) and mortality rates (SUCRA, 82.7 percent).

Furthermore, PN showed the highest probability of shortening the hospitalization length (SUCRA, 77.9 percent), and EN had the highest probability of lowering the rates of feeding-related complications (SUCRA, 81.0 percent).

“More high-quality studies are needed to validate these findings,” the researchers said.