Enteral compared with parenteral nutrition: a meta-analysis

Area of Science:

• Clinical Nutrition
• Critical Care Medicine
• Evidence-Based Medicine

Background:

• Outcomes of enteral nutrition (tube feeding, standard oral diets) versus parenteral nutrition remain unclear.
• Comparison of nutrition interventions, complications, and mortality is essential for patient care.

Purpose of the Study:

• To systematically review and statistically aggregate results from prospective randomized clinical trials (PRCTs).
• To examine the relationships between nutrition interventions, complications, and mortality rates.

Main Methods:

• Conducted a MEDLINE search for PRCTs comparing enteral and parenteral nutrition in adults.
• Utilized fixed-effects meta-analysis to combine relative risks (RRs) for infection, complications, and mortality.
• Data abstraction performed independently by two individuals.

Main Results:

• Twenty-seven studies involving 1828 patients met the inclusion criteria.
• Tube feeding (RR: 0.64) and standard care (RR: 0.77) showed significantly lower infection risk than parenteral nutrition.
• In malnourished populations, standard care was associated with higher mortality (RR: 3.0) and a trend toward increased infection risk.

Conclusions:

• Enteral nutrition (tube feeding and standard care) is linked to a reduced risk of infection compared to parenteral nutrition.
• Standard oral care may elevate mortality and infection risk in malnourished patient groups.
• Parenteral nutrition should be carefully considered in malnourished populations due to potential increased risks.