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Table 2 Methodology and relevant outcome parameters of the included randomized clinical trials of enteral versus parenteral nutrition in critically ill patients

From: Enteral versus parenteral nutrition in critically ill patients: an updated systematic review and meta-analysis of randomized controlled trials

Study

Methods (score)

Mortality, N (%)a

Infections, N (%)b

LOS, days, mean ± SD (N)

Mechanical ventilation, days, mean ± SD (N)

Caloric intakec

EN

PN

EN

PN

EN

PN

EN

PN

EN

PN

1. Rapp et al. 1983 [37]

C.Random: not sure

9/18 (50)

3/20 (15)

NR

 

Hospital 49.4d

Hospital 52.6d

10.3d

10.4d

685

P = 0.001

1750

ITT: no

Blinding: no (4)

2. Adams et al. 1986 [38]

C.Random: not sure

1/23 (4)

3/23 (13)

15/23 (65)

17/23 (74)

ICU 13 ± 11 (19)

ICU 10 ± 10 (17)

12 ± 11 (17)

10 ± 10 (13)

2088 NSf

2572

ITT: yes

Hospital 30 ± 21 (19)

Hospital 31 ± 29 (17)

 

Blinding: no (8)

3. Young et al. 1987 [39]

C.Random: not sure

10/28 (36)

10/23 (43)

5/28 (18)

4/23 (17)

NR

 

NR

1671

P = 0.02

2299

ITT: no

Blinding: no (6)

4. Peterson et al. 1988 [40]

C.Random: not sure

NR

 

2/21 (10)

8/25 (32)

ICU 3.7 ± 0.8 (21)

ICU 4.6 ± 1.0 (25)

NR

Kcal on day 5

2204

P = 0.04

2548

ITT: no

Hospital 13.2 ± 1.6 (21)

Hospital 14.6 ± 1.9 (24)

Blinding: no (5)

5. Cerra et al. 1988 [41]

C.Random: not sure

ICU 7/31 (22)

ICU 8/35 (23)

NR

 

NR

 

NR

Non-protein kcal

1684 NSf

2000

ITT: no

Blinding: no (2)

6. Moore et al. 1989 [42]

C.Random: yes

NR

 

5/29 (17)

11/30 (37)

NR

 

NR

Non-protein kcal on day 5

ITT: no

1847

P = 0.01

2261

Blinding: no (10)

7. Kudsk et al. 1992 [43]

C.Random: not sure

ICU 1/51 (2)

ICU 1/45 (2)

9/51 (16)

18/45 (40)

Hospital 20.5 ± 19.9 (51)

Hospital 19.6 ± 18.8 (45)

2.8 ± 4.9 (51)

3.2 ± 6.7 (45)

Kcal/kg/d

ITT: no

15.7

P < 0.05

19.1

Blinding: single (10)

8. Dunham et al. 1994 [44]

C.Random: not sure

1/12 (7)

1/15 (8)

NR

 

NR

 

NR

NSf

 

ITT: no

Blinding: no (8)

9. Borzotta et al. 1994 [45]

C.Random: not sure

5/28 (18)

1/21 (5)

51/28 (28)

39/21 (21)

Hospitale 39 ± 23.1

Hospitale 36.9 ± 14

NR

2097 NSf

1961

ITT: no

Blinding: no (6)

10. Hadfield et al. 1995 [46]

C.Random: not sure

ICU 2/13 (15)

ICU 6/11 (55)

NR

 

NR

 

NR

NSf

 

ITT: no

Blinding: no (7)

11. Kalfarentzos et al. 1997 [47]

C.Random: not sure

ICU 1/18 (6)

ICU 2/20 (10)

5/18 (28)

0/20 (50)

ICU 11 (5–21)d

ICU 12 (5–24)d

15 (6–16)d

11 (7–31)d

Non-protein kcal/kg/d

ITT: no

Hospital 40 (25–83)d

Hospital 39 (22–73)d

24.1 NSf

24.5

Blinding: single (9)

12. Woodcock et al. 2001 [27]

C.Random: yes

9/17 (53)

5/21 (24)

6/16 (38)

11/21 (52)

33.2 ± 43 (16)

27.3 ± 18.7 (18)

NR

% caloric target (30 kcal/kg/d) achieved

ITT: yes

54.1

P < 0.001

96.7

Blinding: single (12)

13. Casas et al. 2007 [48]

C.Random: no/unsure

Hospital 0/11 (0)

Hospital 2/11 (18)

1/11 (9)

3/11 (27)

Hospital 30.2 (average)

Hospital 30.7 (average)

NR

Kcal/kg/d

ITT: Yes

20.1 NSf

20.8

Blinding: no (8)

14. Chen et al. 2011 [49]

C.Random: yes

20-day 11/49 (22)

20-day 10/49 (20)

5/49 (10)

18/49 (37)

ICU 9.09 ± 2.75

ICU 9.60 ± 3.06

7.95 ± 2.11

8.23 ± 2.42

NR

ITT: yes

Blinding: no (7)

Hospital 23.32 ± 5.6

Hospital 22.24 ± 3.27

15. Justo Meirelles et al. 2011 [21]

C.Random: no

Not specified 1/12 (8.3)

Not specified 1/10 (10)

Total infectious complications 2/12 (16.7)

Total infectious complications 4/10 (40)

ICU 14 (5–26)

ICU 14 (6–24)

NR

Cumulative kcal over 5d

ITT: no

Pneumonia 2/12 (16.7)

Pneumonia 2/10 (20)

5985

P = 0.34

6586

Blinding: no (5)

Sepsis 0

Sepsis 2/10 (20)

16. Wang et al. 2013 [22]

C.Random: no

Hospital 3/61 (5)

Hospital 7/60 (12)

Pancreatic sepsis 13/61 (21)

Pancreatic sepsis 24/60 (40)

NR

 

NR

NR

ITT: no

Blinding: double (7)

MODS 15/61 (24.6)

MODS 22/60 (36.7)

17. Sun et al. 2013 [50]

C.Random: no

Hospital 2/30 (7)

Hospital 1/30 (3)

Pancreatic 3/30 (10)

Pancreatic 10/30 (33)

ICU 9 (5–14)

ICU 12 (8–21)

NR

NR

ITT: no

MODS 5/30 (17)

MODS 13/30 (43)

Blinding: no (6)

SIRS 12/30 (40)

SIRS 22/30 (73)

18. Harvey et al. 2014 [16]

C.Random: yes

ICU 352/1197 (29.4)

ICU 317/1190 (26.6)

Total infectious complications 194/1197 (16.2)g

Total infectious complications 194/1191 (16.3)g

ICU 11.3 ± 12.5 (1197)

ICU 12 ± 13.5 (1190)

8.2 ± 9.3 (1197)

8.7 ± 11.5 (1189)

Cumulative kcal/kg/d over 5d

ITT: yes

Hospital 450/1186 (37.9)

Hospital 431/1185 (36.4)

Pneumonia 143/1197 (11.9)

Pneumonia 135/1191 (11.3)

Hospital 26.8 ± 33.2 (1186)

Hospital 27.5 ± 33.9 (1185)

74 NSf

89

30-day 409/1195 (34.2)

30-day 393/1188 (33.1)

Bloodstream infections 21/1197 (1.8)

Bloodstream infections 27/1191 (2.9)

Blinding: no (8)

90-day 464/1188 (39.1)

90-day 442/1184 (37.3)

Surgical infections 12/1197 (1.0)

Surgical infections 10/1191 (0.8)

  1. Data are presented as total number and percentage for mortality and infections. Data are presented as mean ± standard deviation with total number of patients per group shown in brackets for LOS and mechanical ventilation
  2. C.Random concealed randomization, d days, ITT intention to treat, kcal kilocalories, LOS length of stay, MODS multiple organ dysfunction syndrome, N number, NR not reported, NS not significant, SIRS systemic inflammatory response syndrome
  3. aPresumed hospital mortality unless otherwise specified
  4. bRefers to the number of patients with infections unless otherwise specified
  5. cCaloric intake is presented as the mean daily kcal during the studies’ intervention period or as otherwise specified
  6. dMedian/mean values, no standard deviation reported hence not included in meta-analysis
  7. ePresumed hospital length of stay
  8. fNo data on caloric intake or P value provided, respectively but caloric intake reported to be non-significantly different in the manuscript
  9. gData on ICU patients obtained directly from authors
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