Gastric versus post-pyloric feeding: a systematic review.

Abstract:

BACKGROUND:Our objective was to evaluate the impact of gastric versus post-pyloric feeding on the incidence of pneumonia, caloric intake, intensive care unit (ICU) length of stay (LOS), and mortality in critically ill and injured ICU patients. METHOD:Data sources were Medline, Embase, Healthstar, citation review of relevant primary and review articles, personal files, and contact with expert informants. From 122 articles screened, nine were identified as prospective randomized controlled trials (including a total of 522 patients) that compared gastric with post-pyloric feeding, and were included for data extraction. Descriptive and outcomes data were extracted from the papers by the two reviewers independently. Main outcome measures were the incidence of nosocomial pneumonia, average caloric goal achieved, average daily caloric intake, time to the initiation of tube feeds, time to goal, ICU LOS, and mortality. The meta-analysis was performed using the random effects model. RESULTS:Only medical, neurosurgical and trauma patents were enrolled in the studies analyzed. There were no significant differences in the incidence of pneumonia, percentage of caloric goal achieved, mean total caloric intake, ICU LOS, or mortality between gastric and post-pyloric feeding groups. The time to initiation of enteral nutrition was significantly less in those patients randomized to gastric feeding. However, time to reach caloric goal did not differ between groups. CONCLUSION:In this meta-analysis we were unable to demonstrate a clinical benefit from post-pyloric versus gastric tube feeding in a mixed group of critically ill patients, including medical, neurosurgical, and trauma ICU patients. The incidences of pneumonia, ICU LOS, and mortality were similar between groups. Because of the delay in achieving post-pyloric intubation, gastric feeding was initiated significantly sooner than was post-pyloric feeding. The present study, while providing the best current evidence regarding routes of enteral nutrition, is limited by the small total sample size.

journal_name

Crit Care

authors

Marik PE,Zaloga GP

doi

10.1186/cc2190

keywords:

subject

Has Abstract

pub_date

2003-06-01 00:00:00

pages

R46-51

issue

3

eissn

1364-8535

issn

1466-609X

journal_volume

7

pub_type

杂志文章,meta分析,评审
  • Long term effect of a medical emergency team on cardiac arrests in a teaching hospital.

    abstract:INTRODUCTION:It is unknown whether the reported short-term reduction in cardiac arrests associated with the introduction of the medical emergency team (MET) system can be sustained. METHOD:We conducted a prospective, controlled before-and-after examination of the effect of a MET system on the long-term incidence of ca...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc3906

    authors: Jones D,Bellomo R,Bates S,Warrillow S,Goldsmith D,Hart G,Opdam H,Gutteridge G

    更新日期:2005-01-01 00:00:00

  • Multi-organ point-of-care ultrasound for COVID-19 (PoCUS4COVID): international expert consensus.

    abstract::COVID-19 has caused great devastation in the past year. Multi-organ point-of-care ultrasound (PoCUS) including lung ultrasound (LUS) and focused cardiac ultrasound (FoCUS) as a clinical adjunct has played a significant role in triaging, diagnosis and medical management of COVID-19 patients. The expert panel from 27 co...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/s13054-020-03369-5

    authors: Hussain A,Via G,Melniker L,Goffi A,Tavazzi G,Neri L,Villen T,Hoppmann R,Mojoli F,Noble V,Zieleskiewicz L,Blanco P,Ma IWY,Wahab MA,Alsaawi A,Al Salamah M,Balik M,Barca D,Bendjelid K,Bouhemad B,Bravo-Figueroa P,Br

    更新日期:2020-12-24 00:00:00

  • Septic shock with no diagnosis at 24 hours: a pragmatic multicenter prospective cohort study.

    abstract:BACKGROUND:The lack of a patent source of infection after 24 hours of management of shock considered septic is a common and disturbing scenario. We aimed to determine the prevalence and the causes of shock with no diagnosis 24 hours after its onset, and to compare the outcomes of patients with early-confirmed septic sh...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/s13054-016-1537-5

    authors: Contou D,Roux D,Jochmans S,Coudroy R,Guérot E,Grimaldi D,Ricome S,Maury E,Plantefève G,Mayaux J,Mekontso Dessap A,Brun-Buisson C,de Prost N

    更新日期:2016-11-06 00:00:00

  • Changes in sedation management in German intensive care units between 2002 and 2006: a national follow-up survey.

    abstract:BACKGROUND:The aim of this study, conducted in 2006, was to find out whether changes in sedation management in German intensive care units took place in comparison with our survey from 2002. METHODS:We conducted a follow-up survey with a descriptive and comparative cross-sectional multi-center design. A postal survey ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/cc6189

    authors: Martin J,Franck M,Sigel S,Weiss M,Spies C

    更新日期:2007-01-01 00:00:00

  • Endothelin antagonists in subarachnoid hemorrhage: what next?

    abstract::In the previous issue of Critical Care, Ma and colleagues perform a meta-analysis of five randomized, clinical trials of endothelin antagonists in patients with aneurysmal subarachnoid hemorrhage. There are four trials using clazosentan and one trial with TAK-044. These studies show that endothelin plays an important ...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc11822

    authors: Macdonald RL

    更新日期:2012-11-09 00:00:00

  • Bench-to-bedside review: High-mobility group box 1 and critical illness.

    abstract::High-mobility group box 1 (HMGB1) is a DNA-binding protein that also exhibits proinflammatory cytokine-like activity. HMGB1 is passively released by necrotic cells and also is actively secreted by immunostimulated macrophages, dendritic cells, and enterocytes. Although circulating HMGB1 levels are increased relative t...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc6088

    authors: Fink MP

    更新日期:2007-01-01 00:00:00

  • An observational study to determine the effect of delayed admission to the intensive care unit on patient outcome.

    abstract:INTRODUCTION:Delayed patient admission to the intensive care unit (ICU) due to lack of bed availability is a common problem, but the effect on patient outcome is not fully known. METHODS:A retrospective study was performed using departmental computerised records to determine the effect of delayed ICU admission and tem...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc11650

    authors: O'Callaghan DJ,Jayia P,Vaughan-Huxley E,Gribbon M,Templeton M,Skipworth JR,Gordon AC

    更新日期:2012-10-01 00:00:00

  • Use of noninvasive ventilation in immunocompromised patients with acute respiratory failure: a systematic review and meta-analysis.

    abstract:BACKGROUND:Acute respiratory failure (ARF) remains a common hazardous complication in immunocompromised patients and is associated with increased mortality rates when endotracheal intubation is needed. We aimed to evaluate the effect of early noninvasive ventilation (NIV) compared with oxygen therapy alone in this pati...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1186/s13054-016-1586-9

    authors: Huang HB,Xu B,Liu GY,Lin JD,Du B

    更新日期:2017-01-07 00:00:00

  • Effect of a fever control protocol-based strategy on ventilator-associated pneumonia in severely brain-injured patients.

    abstract:INTRODUCTION:Fever is associated with a poor outcome in severely brain-injured patients, and its control is one of the therapies used in this condition. But, fever suppression may promote infection, and severely brain-injured patients are frequently exposed to infectious diseases, particularly ventilator-associated pne...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-014-0689-4

    authors: Launey Y,Nesseler N,Le Cousin A,Feuillet F,Garlantezec R,Mallédant Y,Seguin P

    更新日期:2014-12-15 00:00:00

  • Intensive insulin treatment improves forearm blood flow in critically ill patients: a randomized parallel design clinical trial.

    abstract:INTRODUCTION:Intensive insulin treatment of critically ill patients was seen as a promising method of treatment, though recent studies showed that reducing the blood glucose level below 6 mmol/l had a detrimental outcome. The mechanisms of the effects of insulin in the critically ill are not completely understood. The ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/cc8202

    authors: Žuran I,Poredos P,Skale R,Voga G,Gabrscek L,Pareznik R

    更新日期:2009-01-01 00:00:00

  • Bending the cost curve in the United States: the role of comparative effectiveness research.

    abstract::Owing to an increasing focus on the rising cost of medical care in the United States, bending the cost curve has become the central tenet of healthcare reform. The exact definition of this phrase, however, remains elusive. In order to affect change in the cost and quality of healthcare, the importance of comparative e...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc9045

    authors: Ghaferi AA

    更新日期:2010-01-01 00:00:00

  • Succinylcholine versus rocuronium for rapid sequence intubation in intensive care: a prospective, randomized controlled trial.

    abstract:INTRODUCTION:Succinylcholine and rocuronium are widely used to facilitate rapid sequence induction (RSI) intubation in intensive care. Concerns relate to the side effects of succinylcholine and to slower onset and inferior intubation conditions associated with rocuronium. So far, succinylcholine and rocuronium have not...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/cc10367

    authors: Marsch SC,Steiner L,Bucher E,Pargger H,Schumann M,Aebi T,Hunziker PR,Siegemund M

    更新日期:2011-08-16 00:00:00

  • Impact of post-traumatic stress symptoms on the health-related quality of life in a cohort study with chronically critically ill patients and their partners: age matters.

    abstract:BACKGROUND:Survivors of an acute critical illness with continuing organ dysfunction and uncontrolled inflammatory responses are prone to become chronically critically ill. As mental sequelae, a post-traumatic stress disorder and an associated decrease in the health-related quality of life (QoL) may occur, not only in t...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-019-2321-0

    authors: Wintermann GB,Petrowski K,Weidner K,Strauß B,Rosendahl J

    更新日期:2019-02-08 00:00:00

  • Effects of increasing compliance with minimal sedation on duration of mechanical ventilation: a quality improvement intervention.

    abstract:INTRODUCTION:In the past two decades, healthcare adopted industrial strategies for process measurement and control. In the industry model, care is taken to avoid minimal deviations from a standard. In healthcare there is scarce data to support that a similar strategy can lead to better outcomes. Briefly, when complianc...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc11335

    authors: Amaral AC,Kure L,Jeffs A

    更新日期:2012-05-08 00:00:00

  • Seven unconfirmed ideas to improve future ICU practice.

    abstract::With imprecise definitions, inexact measurement tools, and flawed study execution, our clinical science often lags behind bedside experience and simply documents what appear to be the apparent faults or validity of ongoing practices. These impressions are later confirmed, modified, or overturned by the results of the ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/s13054-017-1904-x

    authors: Marini JJ,De Backer D,Ince C,Singer M,Van Haren F,Westphal M,Wischmeyer P

    更新日期:2017-12-28 00:00:00

  • Plasma fractalkine is a sustained marker of disease severity and outcome in sepsis patients.

    abstract:INTRODUCTION:Fractalkine is a chemokine implicated as a mediator in a variety of inflammatory conditions. Knowledge of fractalkine release in patients presenting with infection to the Intensive Care Unit (ICU) is highly limited. The primary objective of this study was to establish whether plasma fractalkine levels are ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-015-1125-0

    authors: Hoogendijk AJ,Wiewel MA,van Vught LA,Scicluna BP,Belkasim-Bohoudi H,Horn J,Zwinderman AH,Klein Klouwenberg PM,Cremer OL,Bonten MJ,Schultz MJ,van der Poll T,MARS consortium.

    更新日期:2015-11-25 00:00:00

  • Neurological manifestations of COVID-19: a systematic review.

    abstract:INTRODUCTION:Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the global spread of coronavirus disease (COVID-19). Our understanding of the impact this virus has on the nervous system is limited. Our review aims to inform and improve decision-making among the physicians treating COVID-19 ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-03121-z

    authors: Nepal G,Rehrig JH,Shrestha GS,Shing YK,Yadav JK,Ojha R,Pokhrel G,Tu ZL,Huang DY

    更新日期:2020-07-13 00:00:00

  • Pre-admission functional status impacts the performance of the APACHE IV model of mortality prediction in critically ill patients.

    abstract:BACKGROUND:Functional status (FS) before intensive care unit (ICU) admission is associated with short-term and long-term outcomes among critically ill patients. However, measures of FS are generally not integrated into ICU-specific mortality prediction models. METHODS:This retrospective cohort study used prospectively...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-017-1688-z

    authors: Krinsley JS,Wasser T,Kang G,Bagshaw SM

    更新日期:2017-05-15 00:00:00

  • Initial therapy affects duration of diarrhoea in critically ill patients with Clostridioides difficile infection (CDI).

    abstract:BACKGROUND:Critically ill patients in the intensive care unit (ICU) are at high risk for developing Clostridioides difficile infections (CDI). Risk factors predicting their mortality or standardized treatment recommendations have not been defined for this cohort. Our goal is to determine outcome and mortality associate...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-019-2648-6

    authors: Manthey CF,Dranova D,Christner M,Drolz A,Kluge S,Lohse AW,Fuhrmann V

    更新日期:2019-12-09 00:00:00

  • Risk factors for multidrug resistant bacteria and optimization of empirical antibiotic therapy in postoperative peritonitis.

    abstract:INTRODUCTION:The main objective was to determine risk factors for presence of multidrug resistant bacteria (MDR) in postoperative peritonitis (PP) and optimal empirical antibiotic therapy (EA) among options proposed by Infectious Disease Society of America and the Surgical Infection Society guidelines. METHODS:One hun...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc8877

    authors: Augustin P,Kermarrec N,Muller-Serieys C,Lasocki S,Chosidow D,Marmuse JP,Valin N,Desmonts JM,Montravers P

    更新日期:2010-01-01 00:00:00

  • Recently published papers: from superbugs to superbowl.

    abstract::Several papers are discussed including the CARP (Coronary Artery Revascularisation Prophylaxis) trial, examining the role, if any, of preoperative coronary revascularisation and a study examining the heart rate in the intensive care unit (ICU) population. We also take a look at infections in the ICU with particular re...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc3505

    authors: Tomlinson LA,Forni LG

    更新日期:2005-04-01 00:00:00

  • "Think. Check. Submit." to avoid predatory publishing.

    abstract:: ...

    journal_title:Critical care (London, England)

    pub_type: 信件

    doi:10.1186/s13054-018-2244-1

    authors: Cortegiani A,Shafer SL

    更新日期:2018-11-14 00:00:00

  • Drotrecogin alfa (recombinant human activated protein C) in severe acute pancreatitis.

    abstract:INTRODUCTION:Current concepts of the pathophysiology of acute pancreatitis suggest that disease progression from acinar injury to systemic illness involves a complex interplay between cellular and soluble inflammatory mediators and endothelial beds. To date, there is no specific pharmacologic intervention for acute pan...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc3777

    authors: Jamdar S,Siriwardena AK

    更新日期:2005-08-01 00:00:00

  • "Awake" extracorporeal membrane oxygenation (ECMO): pathophysiology, technical considerations, and clinical pioneering.

    abstract::Venovenous extracorporeal membrane oxygenation (vv-ECMO) has been classically employed as a rescue therapy for patients with respiratory failure not treatable with conventional mechanical ventilation alone. In recent years, however, the timing of ECMO initiation has been readdressed and ECMO is often started earlier i...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/s13054-016-1329-y

    authors: Langer T,Santini A,Bottino N,Crotti S,Batchinsky AI,Pesenti A,Gattinoni L

    更新日期:2016-06-30 00:00:00

  • Vasopressin in vasodilatory shock: hemodynamic stabilization at the cost of the liver and the kidney?

    abstract::Infusing arginine vasopressin (AVP) in advanced vasodilatory shock is usually accompanied by a decrease in cardiac index and systemic oxygen transport. Whether or not such a vasoconstriction impedes regional blood flow and thus visceral organ function, even when low AVP is used, is still a matter of debate. Krejci and...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章,评审

    doi:10.1186/cc6171

    authors: Bracht H,Asfar P,Radermacher P,Calzia E

    更新日期:2007-01-01 00:00:00

  • Association between trends in clinical variables and outcome in intensive care patients with faecal peritonitis: analysis of the GenOSept cohort.

    abstract:INTRODUCTION:Patients admitted to intensive care following surgery for faecal peritonitis present particular challenges in terms of clinical management and risk assessment. Collaborating surgical and intensive care teams need shared perspectives on prognosis. We aimed to determine the relationship between dynamic asses...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/s13054-015-0931-8

    authors: Tridente A,Clarke GM,Walden A,Gordon AC,Hutton P,Chiche JD,Holloway PA,Mills GH,Bion J,Stüber F,Garrard C,Hinds C,GenOSept Investigators.

    更新日期:2015-05-05 00:00:00

  • Our favorite unproven ideas for future critical care.

    abstract::The future of critical care medicine will be shaped not only by the evidence-validated foundations of science, but also by innovations based on unproven and, in many cases, untested concepts and thoughtful visions of scientists and clinicians familiar with the complex problems actually faced in clinical practice. Clin...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc11507

    authors: Marini JJ,Vincent JL,Wischmeyer P,Singer M,Gattinoni L,Ince C,Gan TJ

    更新日期:2013-01-01 00:00:00

  • Value of arterial blood gas analysis in patients with acute dyspnea: an observational study.

    abstract:INTRODUCTION:The diagnostic and prognostic value of arterial blood gas analysis (ABGA) parameters in unselected patients presenting with acute dyspnea to the Emergency Department (ED) is largely unknown. METHODS:We performed a post-hoc analysis of two different prospective studies to investigate the diagnostic and pro...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc10268

    authors: Burri E,Potocki M,Drexler B,Schuetz P,Mebazaa A,Ahlfeld U,Balmelli C,Heinisch C,Noveanu M,Breidthardt T,Schaub N,Reichlin T,Mueller C

    更新日期:2011-01-01 00:00:00

  • Statistics review 4: sample size calculations.

    abstract::The present review introduces the notion of statistical power and the hazard of under-powered studies. The problem of how to calculate an ideal sample size is also discussed within the context of factors that affect power, and specific methods for the calculation of sample size are presented for two common scenarios, ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc1521

    authors: Whitley E,Ball J

    更新日期:2002-08-01 00:00:00

  • Community-acquired polymicrobial pneumonia in the intensive care unit: aetiology and prognosis.

    abstract:INTRODUCTION:The frequency and clinical significance of polymicrobial aetiology in community-acquired pneumonia (CAP) patients admitted to the ICU have been poorly studied. The aim of the present study was to describe the prevalence, clinical characteristics and outcomes of severe CAP of polymicrobial aetiology in pati...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc10444

    authors: Cillóniz C,Ewig S,Ferrer M,Polverino E,Gabarrús A,Puig de la Bellacasa J,Mensa J,Torres A

    更新日期:2011-01-01 00:00:00