Assessment of nutritional support in critically ill patients and its correlation with outcomes at respiratory intensive care unit at Zagazig University Hospitals in (2014–2015)

Comparison of Early Enteral Nutrition Versus Early Parenteral Nutrition in Critically Ill Patients: A Systematic Review and Meta-Analysis

BACKGROUND

Nutritional support is crucial in critically ill patients to enhance recovery, reduce infections, and improve outcomes. This meta-analysis compared early enteral nutrition (EEN) and early parenteral nutrition (EPN) to evaluate their efficacy in adult critically ill patients.

METHODS

A systematic review of 14 studies involving 7618 patients was conducted, including randomized controlled trials, prospective cohorts, and retrospective analyses. The primary outcomes were mortality and infectious complications, while secondary outcomes included intensive care unit length of stay (ICU-LOS), hospital length of stay (H-LOS), mechanical ventilation days, and gastrointestinal (GI) complications.

RESULTS

The results showed no significant difference in mortality between EEN and EPN (OR 1.03, 95% CI 0.93-1.14). EEN reduced bloodstream infections (OR 0.73, 95% CI 0.57-0.93), ICU-LOS (MD -0.18 days, 95% CI -0.33 to -0.04), and H-LOS (MD -1.15 days, 95% CI -1.38 to -0.93). However, EEN was associated with higher GI complications, such as vomiting and diarrhea (OR 2.25, 95% CI 1.97-2.58), while mechanical ventilation days showed no significant difference.

CONCLUSIONS

These findings support prioritizing EEN in critically ill patients with functional gastrointestinal systems to improve infection control and recovery while emphasizing the importance of careful monitoring to mitigate gastrointestinal complications.

Parenteral Nutrition Administration by Critical Care Nurses in Iran: A Performance Evaluation

In Iran, nurses are responsible for administering parenteral nutrition (PN) to hospitalized patients in intensive care units (ICUs). However, little information is available among nurses in Iran regarding best practices in PN administration. This study evaluates the performance of critical care nurses in Iran in the administration of PN. The performance of 50 nurses in the administration of PN in the ICU was observed 3 times during a 5-month period for a total of 150 observations. A researcher-developed checklist, "Critical Care Nurses' Performance in Parenteral Nutrition Administration," was used for data collection. The total score in this checklist ranged from 0 to 52. Based on the procedural steps in the checklist and whether the steps were performed appropriately, nurses' performance was scored as poor, moderate, or good. The mean score of nurses' performances in PN administration skills was 24.6 ± 2.5. This study found that 46 nurses had moderate skill levels in PN administration, and 3 demonstrated poor skills. Overall, the results indicated that critical care nurses in Iran have poor to moderate PN administration skills.