Clinical effects and safety of semi-solid feeds in tube-fed patients: a meta-analysis and systematic review

Abstract

Background: Enteral nutrition is a very important form of treatment for critically ill patients. This meta-analysis aimed to evaluate the clinical effects and safety of semi-solid feeds in tube-fed patients. Methods: Two researchers searched PubMed, clinical trials, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Weipu databases for randomized controlled trials (RCTs) on the clinical effects and safety of semi-solid feeds in tube-fed patients until 10 October 2023. The quality evaluation tool recommended by the Cochrane Library was used to evaluate the quality of included RCTs. RevMan 5.4 software was used for data analysis. Results: A total of eight RCTs involving 823 tube-fed patients were included in this meta-analysis. A synthesized outcome indicated that semi-solid feeds reduced the incidence of diarrhea (RR = 0.32, 95%CI:0.20–0.50, P < 0.001), vomiting (RR = 0.31, 95%CI:0.15–0.64, P = 0.002), abdominal distension (RR = 0.41, 95%CI:0.22–0.76, P = 0.005), length of intensive care unit (ICU) stay (MD = −3.61, 95%CI: −6.74 to −0.48, P = 0.02), and length of hospital stay (MD = −7.14, 95%CI: −10.31 to −3.97, P < 0.01) in tube-fed patients. Enteric feeding had no effect on the 30-day mortality (RR = 0.55, 95%CI: 0.19−1.56, P = 0.26). No publication bias was detected by the Egger's test results (all P > 0.05). Conclusion: Semi-solid feeds are beneficial in reducing the incidence of diarrhea, abdominal distension, vomiting, and hospital stay. More high-quality studies are needed in the future to verify the effects of semi-solid feeds on mortality.