Can early enteral nutrition decrease mortality?

Early enteral nutrition, provided within 24 h of injury or intensive care unit admission, significantly reduces mortality in critically ill patients: a metaanalysis of randomised controlled trials.


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Early enteral nutrition, provided within 24 h of injury or intensive care unit admission, significantly reduces mortality in critically ill patients: a metaanalysis of randomised controlled trials.

In my quest for sort out the answer of when to initiate enteral nutrition in my critically ill ICU patients, the data leans toward starting early. In this meta-analysis that was published in 2009, despite the sample sizes being very small, they were able to find a benefit regarding mortality and pneumonias when you start feeding patients within 24 hours. How small you ask? Well, 234 in the group that determined a benefit in mortality and just 80 in the group that determined a benefit towards pneumonia of early feeding. We need larger studies. All these authors admit this. We need some super ambitious RD's out there to take this bull by the horns and definitely answer these questions for us! A 🎩 tip to the authors!

-EJ

Doig GS, Heighes PT, Simpson F, Sweetman EA, Davies AR. Early enteral nutrition, provided within 24 h of injury or intensive care unit admission, significantly reduces mortality in critically ill patients: a metaanalysis of randomised controlled trials. Intensive Care Med. 2009;35(12): 2018-2027.

The effect of melatonin on delirium in hospitalised patients: A systematic review and meta-analyses with trial sequential analysis

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We are all trying to combat delirium by all possible means. Getting pts their glasses and hearing aides. Keeping the lights on during the day. Having family around to speak to them. We’ve also had recent trials which have been quite disappointing using medications. Could there be a good cheap medication to prevent #delirium? This paper on using #melatonin is a strong meta analysis that looks into this and could potentially change my practice... but not for the reasons on the surface. I’ve even recently heard of using melatonin for sepsis, but that’s a discussion for another day and something else I’m going to dig into. Either way, a 🎩 tip to the authors.

-EJ

Although great care has been taken to ensure that the information in this post is accurate, eddyjoemd, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.

Oxygen There may be such a thing as too much oxygen..

The effect of hyperoxia on mortality in critically ill patients: a systematic review and meta analysis

Do your patients have supplemental oxygen and sats of 100% on the monitor? If so, they may be getting too much oxygen. Wean the supplemental oxygen as we have data that this causes harm. I encourage you to read this article which you can download on my website, eddyjoemd.com. I’m making an effort to review articles for you all that you can download for free and not have to pay ridiculous fees to stay up to date. You can like my posts and YouTube videos and donate $10 to your favorite charity instead 😁. Thank you to the authors, as always because I do not do research myself.

-EJ


Link to Abstract

Link to PDF

Although great care has been taken to ensure that the information in this post is accurate, eddyjoemd, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.