Related Experiment Videos
Impact of evidence-based feeding protocols on clinical outcomes and nutritional delivery in critically ill adults: A
Sadaharu Asami1, Akira Ouchi2, Naoki Higashibeppu3
1Department of Cardiology, Musashino Tokushukai Hospital, Nishi-tokyo, Japan.
Background & Aims:
Evidence-based feeding protocols are used to standardize nutritional care in critically ill adults, but their effects on clinical outcomes remain uncertain. We conducted a systematic review and meta-analysis to evaluate the impact of these protocols on clinical outcomes, and to quantify their effects on nutritional delivery (feeding efficiency).
Methods:
We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, CINAHL, ClinicalTrials.gov, and ICTRP up to December 2025 for randomized controlled trials (RCTs) to compare feeding protocols with usual care in critically ill adults. The primary outcome was the mortality rate. Secondary outcomes included the length of stay in the intensive care unit, hospital length of stay, length of mechanical ventilation, adverse events, pneumonia, vomiting, and organ dysfunction. Additional outcomes were nutritional delivery outcomes. We used the Cochrane Risk of Bias 2 and the GRADE approach to assess the quality and certainty of the evidence. PROSPERO registration: CRD42023391771.
Results:
Nine RCTs (5369 patients) were included. Evidence-based feeding protocols resulted in little to no difference in mortality (risk ratio (RR), 0.97; 95% confidence interval (CI), 0.83 to 1.13), length of mechanical ventilation (mean difference (MD), 0.34 days; 95% CI, -1.29 to 1.96), or vomiting (RR, 1.49; 95% CI, 0.68 to 3.27). The protocols likely resulted in little to no difference in adverse events (RR, 0.49; 95% CI, 0.12 to 1.95). The protocols reduced the time to enteral nutrition (EN) initiation and increased daily caloric and protein intake.
Conclusion:
Evidence-based feeding protocols were associated with improved nutritional delivery but little to no difference in key clinical outcomes in critically ill adults. Future research should focus on the consistent integration of patient-centered core outcome sets alongside the establishment of standardized, prespecified safety and gastrointestinal outcome frameworks.
Related Concept Videos
01:27Nursing Clinical Information System
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
01:15Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube through...
01:30Current Trends in Nursing II
01:29Nursing Interventions II: Selecting and Classifying the Nursing Interventions
01:25Role of Communication in the Nursing Process II: Planning and Implementation
01:11Guidelines for Writing Outcome
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care evaluation by...