Chinese Journal of Emergency and Critical Care Nursing >
Meta-analysis of the impact of gastric juice reinfusion on enteral feeding intolerance in critically ill patients
Received date: 2025-04-18
Online published: 2026-04-02
Supported by
Guiding Science and Technology Program of Ganzhou City in 2022(20222ZDX7717)
Objective To systematically evaluate the impact of gastric juice reinfusion on enteral feeding intolerance in critically ill patients. Methods A systematic search was conducted in PubMed，Web of Science，Cochrane Library，Ovid，CINAHL，Embase，China National Knowledge Infrastructure，Wanfang Data，and VIP Database for randomized controlled trials（RCTs） regarding the reinfusion of gastric juice in critically ill patients receiving enteral nutrition. The search time period was from the establishment of the database to January 2025. Two researchers independently performed literature screening，data extraction，and quality assessment，with RevMan 5.4 software used for meta-analysis. Results A total of eight RCTs involving 574 patients were ultimately included. Meta-analysis indicated that reinfusion of gastric juice was superior to its disposal in reducing the incidence of nausea/vomiting[RR=0.44，95%CI（0.21，0.95），P=0.036]，abdominal bloating[RR=0.49，95%CI（0.31，0.79），P=0.003]，and constipation[RR=0.22，95%CI（0.05，0.99），P=0.048]，with statistically significant differences. However，there were no significant differences in gastric residual volume[MD=-9.55，95%CI（-21.83，2.73），P=0.127]，the incidence of gastric emptying delay[RR=1.09，95%CI（0.72，1.65），P=0.692]，diarrhea[RR=0.60，95%CI（0.33，1.11），P=0.102]，serum albumin（SMD=0.18，95%CI[-0.13，0.49]，P=0.248），plasma total protein（SMD=0.18，95%CI[-0.13，0.50]，P=0.245），or the incidence of hypokalemia（RR=0.75，95%CI[0.47，1.18]，P=0.213）. Differences in hemoglobin（SMD=0.41，95%CI[-0.04，0.87]，P=0.077） and the incidence of electrolyte disturbances（RR=0.56，95%CI[0.29，1.08]，P=0.085） were close to statistical significance. Conclusion Reinfusion of gastric juice is significantly advantageous in reducing the incidence of nausea/vomiting，abdominal bloating，and constipation，while its effects on improving gastric residual volume，gastric emptying delay，diarrhea，nutritional status，and electrolyte levels are not significant. Further validation with more high-quality RCTs is warranted. In clinical nursing practice，it is recommended to implement gastric juice reinfusion strategies gradually based on the specific degree of gastric retention in critically ill patients to improve gastrointestinal symptoms.
XIAO Lele , XIAO Li , WANG Jing , XIE Zhifen , YANG Liu , LIU Xiaolan . Meta-analysis of the impact of gastric juice reinfusion on enteral feeding intolerance in critically ill patients[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026 , 7(4) : 488 -495 . DOI: 10.3761/j.issn.2096-7446.2026.04.018
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