Objective To systematically evaluate the effects of volume based and rate based feeding on the nutrition intake of intensive care patients. Methods Cochrane Library,PubMed,Web of Science,CNKI,Wanfang Database,China Biomedical Database and VIP were searched for randomized controlled trials and quasi-experimental studies related to the effects of volume-based and rate-based feeding on compliance rate of nutrition in critically ill patients from the database's inception to August 2022. After literature screening,data extraction and the risk of bias were evaluated independently by two researchers,meta-analysis was performed using RevMan 5.3 software. Results A total of 5 randomized controlled trials and 4 quasi-experimental studies were included,including 718 patients. Meta-analysis showed that compared with rate-based feeding,volume-based feeding scheme can improve the compliance rate of energy intake[MD=16.58,95%CI（11.15,20.01）,P<0.001] and protein intake compliance rate in intensive care patients,but the differences in the incidence of diarrhea[OR=1.07,95%CI（0.72,1.58）,P=0.75],the inci-dence of vomiting/reflux[OR=0.77,95%CI（0.48,1.26）,P=0.30],ICU hospitalization length[MD=-0.11,95%CI（-0.15,0.94）,P=0.84] and other aspects were not statistically significant between the two groups. Conclusion Compared with the traditional enteral nutrition scheme,volume based feeding could significantly improve the nutritional intake of critical patients,but did not increase the incidence of complications of enteral feeding,and could effectively ensure the nutritional supply of patients.
[1] 王先美,陈卫挺,叶立刚,等. 浙江省ICU危重症患者肠内营养早期腹泻的调查研究[J]. 中华急诊医学杂志,2018,27(10):1142-1147.
Wang XM,Chen WT,Ye LG,et al.Investigation on early diarrhea during enteral nutrition in critically ill patients admitted to ICU in Zhejiang Province[J]. Chin J Emerg Med,2018,27(10):1142-1147.
[2] 朱力,绳宇. 持续与间断肠内营养喂养方式对危重患者肠内营养耐受性的影响分析[J]. 中华现代护理杂志,2017,23(8):1113-1116.
Zhu L,Sheng Y.Effect of continuous and intermittent enteral feeding on critical patients’ tolerance of enteral nutrition[J]. Chin J Mod Nurs,2017,23(8):1113-1116.
[3] McClave SA,Taylor BE,Martindale RG,et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient:society of critical care medicine(SCCM) and American Society for Parenteral and Enteral Nutrition(A.S.P.E.N.)[J]. JPEN J Parenter Enteral Nutr,2016,40(2):159-211.
[4] Singer P,Blaser AR,Berger MM,et al.ESPEN guideline on clinical nutrition in the intensive care unit[J]. Clin Nutr,2019, 38(1):48-79.
[5] McClave SA,Martindale RG,Rice TW,et al. Feeding the critically ill patient[J]. Crit Care Med,2014,42(12):2600-2610.
[6] Heyland DK,Dhaliwal R,Wang M,et al.The prevalence of iatrogenic underfeeding in the nutritionally ‘at-risk’ critically ill patient:results of an international,multicenter,prospective study[J]. Clin Nutr,2015,34(4):659-666.
[7] Heyland DK,Murch L,Cahill N,et al.Enhanced protein-energy provision via the enteral route feeding protocol in critically ill patients:results of a cluster randomized trial[J]. Crit Care Med,2013,41(12):2743-2753.
[8] Declercq B,Deane AM,Wang M,et al.Enhanced Protein-Energy Provision via the Enteral Route Feeding(PEPuP) protocol in critically ill surgical patients:a multicentre prospective eva-luation[J]. Anaesth Intensive Care,2016,44(1):93-98.
[9] Cumpston M,Li T,Page MJ,et al. Updated guidance for trusted systematic reviews:a new edition of the Cochrane Handbook for Systematic Reviews of Interventions[J]. Cochrane Da-tabase Syst Rev,2019,10:ED000142.
[10] 王浩,唐晓宇,王和平,等. ROBINS-I:评估非随机干预性研究偏倚风险的新工具[J]. 中国循证心血管医学杂志,2018,10(7):789-793.
Wang H,Tang XY,Wang HP,et al.ROBINS-I:a new tool for evaluating the risk of bias in non-randomized interventional research[J]. Chin J Evid Based Cardiovasc Med,2018,10(7):789-793.
[11] 罗德惠,万翔,刘际明,等. 如何实现从样本量、中位数、极值或四分位数到均数与标准差的转换[J]. 中国循证医学杂志,2017,17(11):1350-1356.
Luo DH,Wan X,Liu JM,et al.How to estimate the sample mean and standard deviation from the sample size,median,extremes or quartiles?[J]. Chin J Evid Based Med,2017,17(11):1350-1356.
[12] Wan X,Wang WQ,Liu JM,et al.Estimating the sample mean and standard deviation from the sample size,median,range and/or interquartile range[J]. BMC Med Res Methodol,2014, 14:135.
[13] McClave SA,Saad MA,Esterle M,et al. Volume-based feeding in the critically ill patient[J]. JPEN J Parenter Enteral Nutr,2015,39(6):707-712.
[14] Haskins IN,Baginsky M,Gamsky N,et al.Volume-based enteral nutrition support regimen improves caloric delivery but may not affect clinical outcomes in critically ill patients[J]. JPEN J Parenter Enteral Nutr,2017,41(4):607-611.
[15] Fetterplace K,Deane AM,Tierney A,et al.Targeted full energy and protein delivery in critically ill patients:a pilot randomized controlled trial(FEED trial)[J]. JPEN J Parenter Enteral Nutr,2018,42(8):1252-1262.
[16] Bharal M,Morgan S,Husain T,et al.Volume based feeding versus rate based feeding in the critically ill:a UK study[J]. J Intensive Care Soc,2019,20(4):299-308.
[17] Brierley-Hobson S,Clarke G,O'Keeffe V. Safety and efficacy of volume-based feeding in critically ill,mechanically ventilated adults using the ‘Protein & Energy Requirements Fed for Every Critically ill patient every Time’ (PERFECT) protocol:a before-and-after study[J]. Crit Care,2019,23(1):105.
[18] Krebs ED,O’Donnell K,Berry A,et al. Volume-based feeding improves nutritional adequacy in surgical patients[J]. Am J Surg,2018,216(6):1155-1159.
[19] 戚桂艳,宋燕秋,刘文悦,等. 基于容量的喂养策略对机械通气患者的影响[J]. 临床急诊杂志,2020,21(10):789-793.
Qi GY,Song YQ,Liu WY,et al.Effects of volume-based feeding protocol in critically ill patients with mechanical ventilation[J]. J Clin Emerg,2020,21(10):789-793.
[20] 杨双双,戚桂艳,宋燕秋,等. 基于容量喂养策略在ICU机械通气患者中的应用及对免疫功能指标的影响[J]. 中国病案,2022, 23(1):91-94.
Yang SS,Qi GY,Song YQ,et al.Application of volume-based feeding strategy in ICU patients with mechanical ventilation and its effect on immune function indexes[J]. Chin Med Rec,2022,23(1):91-94.
[21] 路艳霞,马靓. 基于容量的肠内营养输注方案在ICU患者中的应用[J]. 中华急危重症护理杂志,2020,1(1):53-57.
Lu YX,Ma L.Effect of volume-based enteral nutrition feeding in critical patients[J]. Chin J Emerg Crit Care Nurs,2020,1(1):53-57.
[22] Silva CFA,de Vasconcelos SG,da Silva TA,et al. Permissive or trophic enteral nutrition and full enteral nutrition had similar effects on clinical outcomes in intensive care:a sys-tematic review of randomized clinical trials[J]. Nutr Clin Pract,2018,33(3):388-396.
[23] McClave SA,Sexton LK,Spain DA,et al. Enteral tube feeding in the intensive care unit:factors impeding adequate delivery[J]. Crit Care Med,1999,27(7):1252-1256.
[24] Yeh DD,Peev MP,Quraishi SA,et al.Clinical outcomes of ina-dequate calorie delivery and protein deficit in surgical intensive care patients[J]. Am J Crit Care,2016,25(4):318-326.
[25] Holyk A,Belden V,Sirimaturos M,et al.Volume-based feeding enhances enteral delivery by maximizing the optimal rate of enteral feeding(FEED MORE)[J]. JPEN J Parenter Enteral Nutr,2020,44(6):1038-1046.
[26] Roberts S,Brody R,Rawal S,et al.Volume-based vs rate-based enteral nutrition in the intensive care unit:impact on nutrition delivery and glycemic control[J]. JPEN J Parenter Ente-ral Nutr,2019,43(3):365-375.
[27] Swiatlo T,Berta JW,Mauldin K.A quality improvement study:comparison of volume-based and rate-based tube feeding effi-cacy and clinical outcomes in critically ill patients[J]. Nutr Clin Pract,2020,35(3):578-583.
[28] Dhaliwal R,Cahill N,Lemieux M,et al.The Canadian critical care nutrition guidelines in 2013:an update on current recommendations and implementation strategies[J]. Nutr Clin Pract,2014,29(1):29-43.
