TY - JOUR
T1 - Micronutrient intake from enteral nutrition in critically ill adults
T2 - A systematic review of randomised controlled trials
AU - Breik, Lina
AU - Tatucu-Babet, Oana A.
AU - Ridley, Emma J.
N1 - Funding Information:
L.B. has received sponsorship from Fresenius Kabi (Australia) to attend an education event in 2018 unrelated to this study. E.J.R. has unrestricted grant funding from Baxter Healthcare (United States), Nestle and Nutricia (Australia) that does not relate to this project and has received honorarium from Baxter Healthcare (United States and Australia), Nestle and Nutricia (Australia). E.J.R. is supported by a National Health and Medical Research Council (NHMRC) Emerging Leadership Fellowship. E.J.R is an Editor at Australian Critical Care. E.J.R. did not manage this article and was not aware of who the handling Editor was. This process prevents authors who also hold an Editorial Role to influence the editorial decisions made.
Publisher Copyright:
© 2021
PY - 2022/9
Y1 - 2022/9
N2 - Objectives: The primary objective was to compare the intake of important micronutrients provided from enteral nutrition to critically ill patients with the Australia and New Zealand recommended dietary intakes. A secondary objective was to compare the upper levels of intake and investigate prespecified subgroups. Review method used: A systematic literature review was performed. Data sources: MEDLINE, EMBASE, CINAHL, and CENTRAL were used. Review methods: Databases were searched for randomised controlled trials that investigated an enteral nutrition intervention as the sole source of nutrition, were published in English between January 2000 and January 8th, 2021, and provided data to calculate micronutrient intake. The primary outcome was the % recommended dietary intake. The quality of individual trials was assessed using the Cochrane Risk of Bias Tool. Outcomes are presented as either mean ± standard deviation or median [interquartile range], with a p < 0.05 considered statistically significant. Results: Thirteen trials were included (n = 1538 patients). Trials investigating hypocaloric nutrition were excluded from the primary outcome assessment (conducted in nine trials (n = 1220)). All nine trials delivered ≥104% of the recommended dietary intakes and <100% of the upper level of intakes of all micronutrients. In subgroup analyses, trials with ≥80% target energy delivered a higher % of the recommended dietary intake of vitamin B12, thiamine, zinc, and vitamin C. Acute Physiology and Chronic Health Evaluation scores ≥20 delivered a higher % of the recommended dietary intake of vitamin B12 and vitamin A. Antioxidant formulas compared with standard formulas delivered a higher % recommended dietary intake of vitamin C and thiamine. In the four trials that investigated hypocaloric feeding compared with control, there was no difference in micronutrient intake. The quality was low. Conclusions: Enteral nutrition delivery frequently met the recommended dietary intakes for all micronutrients investigated and did not exceed the upper levels of intake set for health. PROSPERO Registration: CRD42020178333.
AB - Objectives: The primary objective was to compare the intake of important micronutrients provided from enteral nutrition to critically ill patients with the Australia and New Zealand recommended dietary intakes. A secondary objective was to compare the upper levels of intake and investigate prespecified subgroups. Review method used: A systematic literature review was performed. Data sources: MEDLINE, EMBASE, CINAHL, and CENTRAL were used. Review methods: Databases were searched for randomised controlled trials that investigated an enteral nutrition intervention as the sole source of nutrition, were published in English between January 2000 and January 8th, 2021, and provided data to calculate micronutrient intake. The primary outcome was the % recommended dietary intake. The quality of individual trials was assessed using the Cochrane Risk of Bias Tool. Outcomes are presented as either mean ± standard deviation or median [interquartile range], with a p < 0.05 considered statistically significant. Results: Thirteen trials were included (n = 1538 patients). Trials investigating hypocaloric nutrition were excluded from the primary outcome assessment (conducted in nine trials (n = 1220)). All nine trials delivered ≥104% of the recommended dietary intakes and <100% of the upper level of intakes of all micronutrients. In subgroup analyses, trials with ≥80% target energy delivered a higher % of the recommended dietary intake of vitamin B12, thiamine, zinc, and vitamin C. Acute Physiology and Chronic Health Evaluation scores ≥20 delivered a higher % of the recommended dietary intake of vitamin B12 and vitamin A. Antioxidant formulas compared with standard formulas delivered a higher % recommended dietary intake of vitamin C and thiamine. In the four trials that investigated hypocaloric feeding compared with control, there was no difference in micronutrient intake. The quality was low. Conclusions: Enteral nutrition delivery frequently met the recommended dietary intakes for all micronutrients investigated and did not exceed the upper levels of intake set for health. PROSPERO Registration: CRD42020178333.
KW - Antioxidants
KW - Critical illness
KW - Enteral nutrition
KW - Intensive care unit
KW - Micronutrients
KW - Nutritional therapy
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=85118329619&partnerID=8YFLogxK
U2 - 10.1016/j.aucc.2021.09.001
DO - 10.1016/j.aucc.2021.09.001
M3 - Review Article
C2 - 34756550
AN - SCOPUS:85118329619
SN - 1036-7314
VL - 35
SP - 564
EP - 574
JO - Australian Critical Care
JF - Australian Critical Care
IS - 5
ER -