{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T17:40:28Z","timestamp":1793814028162,"version":"4.6.1"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T00:00:00Z","timestamp":1692576000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The appropriate strategy for enteral feeding in critically ill patients still remains controversial. Therefore, we conducted this meta-analysis to compare the effect of intermittent versus continuous enteral feeding method for critically ill patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Electronic databases including PubMed, Embase, Scopus, and Cochrane Library were searched up to April 10th, 2023 for randomized controlled trials evaluating the effect of intermittent versus continuous enteral feeding for critically ill patients. The primary outcomes were feeding intolerances, including diarrhea, vomiting, distension, constipation, gastric retention, and aspiration pneumonia. The secondary outcomes were mortality in intensive care unit (ICU), length of stay in ICU, and achievement of nutritional goal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirteen studies with a total of 884 patients were analyzed in this meta-analysis. Overall, the use of intermittent enteral feeding was associated with higher incidence of diarrhea (OR 1.66, 95%CI 1.13 to 2.43, I\n                      <jats:sup>2<\/jats:sup>\n                      =\u200916%) and distension (OR 2.29, 95%CI 1.16 to 4.51, I\n                      <jats:sup>2<\/jats:sup>\n                      =\u20090%), lower incidence of constipation (OR 0.58, 95%CI 0.37 to 0.90, I\n                      <jats:sup>2<\/jats:sup>\n                      =\u20090%), and longer length of ICU stay (MD 1.09, 95%CI 0.53 to 1.64, I\n                      <jats:sup>2<\/jats:sup>\n                      =\u20090%). Moreover, no significant difference was identified for other outcome measures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In critically ill patients, the implementation of intermittent enteral feeding was associated with higher incidence of diarrhea and distension, longer length of ICU stay, but lower occurrence of constipation. Nevertheless, the absence of sufficient high-quality randomized controlled clinical trials precludes any definitive conclusions regarding the optimal approach to enteral feeding in this population. There is an imperative need for more studies to further assess the efficacy of the two enteral feeding strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2023.1214774","type":"journal-article","created":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T05:05:17Z","timestamp":1692594317000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":31,"title":["The effect of intermittent versus continuous enteral feeding for critically ill patients: a meta-analysis of randomized controlled trials"],"prefix":"10.3389","volume":"10","author":[{"given":"Jing","family":"Qu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoya","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaobo","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuzhong","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leshuang","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,8,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1038\/s41430-017-0008-7","article-title":"Nutritional assessment of critically ill patients: validation of the modified NUTRIC score","volume":"72","author":"de Vries","year":"2018","journal-title":"Eur J Clin Nutr"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.clnu.2018.08.037","article-title":"ESPEN guideline on clinical nutrition in the intensive care unit","volume":"38","author":"Singer","year":"2019","journal-title":"Clin Nutr"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"2851","DOI":"10.3390\/nu13082851","article-title":"Nutrition in the intensive care unit-a narrative review","volume":"13","author":"Hill","year":"2021","journal-title":"Nutrients"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.jclinane.2018.08.008","article-title":"The effect of enteral versus parenteral nutrition for critically ill patients: a systematic review and meta-analysis","volume":"51","author":"Zhang","year":"2018","journal-title":"J Clin Anesth"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1016\/j.suc.2011.04.006","article-title":"Overview of enteral and parenteral feeding access techniques: principles and practice","volume":"91","author":"Phillips","year":"2011","journal-title":"Surg Clin North Am"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1186\/s40560-019-0378-0","article-title":"Enteral tolerance in critically ill patients","volume":"7","author":"Tatsumi","year":"2019","journal-title":"J Intensive Care"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1097\/MCC.0000000000000801","article-title":"Overcoming challenges to enteral nutrition delivery in critical care","volume":"27","author":"Wischmeyer","year":"2021","journal-title":"Curr Opin Crit Care"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1097\/MCO.0000000000000447","article-title":"Intermittent versus continuous feeding in critically ill adults","volume":"21","author":"Patel","year":"2018","journal-title":"Curr Opin Clin Nutr Metab Care"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"790","DOI":"10.1002\/ncp.10105","article-title":"Methods of enteral nutrition Administration in Critically ill Patients: continuous, cyclic, intermittent, and bolus feeding","volume":"33","author":"Ichimaru","year":"2018","journal-title":"Nutr Clin Pract"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/s13613-015-0051-2","article-title":"Feeding critically ill patients the right 'whey': thinking outside of the box. 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