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Objectives <p>Nutrition support improves ICU patients’ nutritional status and outcomes, but optimal models remain unclear. We performed a Bayesian and frequentist network meta-analysis (NMA) and systematic review to assess improvements in nutritional indicators and clinical outcomes.</p> Methods <p>We systematically searched PubMed, Embase, Cochrane, and Web of Science up to November 23, 2023 for Randomised controlled trials (RCT), case-control studies, and cohort studies. Outcomes mainly included serum albumin values, length of hospitalization, infection rates, feeding-related complication rates and mortality. All the analyses were conducted using STATA 17.0 and R software version 4.5.1.</p> Results <p>A total of 26 studies were included, enrolling 7698 critically ill ICU patients receiving four different types of nutrition support, including parenteral nutrition (PN), enteral nutrition (EN), enteral immunonutrition (EIN), and parenteral nutrition combined with enteral nutrition (PN + EN). The NMA results showed that according to SUCRA, PN + EN had the highest probability of being the most effective intervention for improving serum albumin values (SUCRA = 84.5%) and reducing infection rates (SUCRA = 83.0%) and mortality rates (SUCRA = 82.7%). PN had the highest probability of reducing the length of hospitalization (SUCRA = 77.9%), while EIN had the highest probability of reducing feeding-related complication rates (SUCRA = 81.0%).</p> Conclusion <p>The available evidence suggests that all four models of nutrition support affect the nutritional status and clinical outcomes of critically ill patients in the ICU to varying degrees. However, EN + PN appears to be the most effective approach in improving clinical outcomes and nutrition support in critically ill ICU patients. More high-quality studies are needed to validate these findings.</p>

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Comparison of the effects of different models of nutrient supply on nutritional status and clinical outcomes in ICU patients: a systematic review and network meta-analysis

  • 期刊论文

  • 发表日期：

    2026年2月19日

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  • Tingting Shi,
  • Ting Li,
  • Xiaoling Zhu,
  • Yunmei Chen

摘要

Objectives

Nutrition support improves ICU patients’ nutritional status and outcomes, but optimal models remain unclear. We performed a Bayesian and frequentist network meta-analysis (NMA) and systematic review to assess improvements in nutritional indicators and clinical outcomes.

Methods

We systematically searched PubMed, Embase, Cochrane, and Web of Science up to November 23, 2023 for Randomised controlled trials (RCT), case-control studies, and cohort studies. Outcomes mainly included serum albumin values, length of hospitalization, infection rates, feeding-related complication rates and mortality. All the analyses were conducted using STATA 17.0 and R software version 4.5.1.

Results

A total of 26 studies were included, enrolling 7698 critically ill ICU patients receiving four different types of nutrition support, including parenteral nutrition (PN), enteral nutrition (EN), enteral immunonutrition (EIN), and parenteral nutrition combined with enteral nutrition (PN + EN). The NMA results showed that according to SUCRA, PN + EN had the highest probability of being the most effective intervention for improving serum albumin values (SUCRA = 84.5%) and reducing infection rates (SUCRA = 83.0%) and mortality rates (SUCRA = 82.7%). PN had the highest probability of reducing the length of hospitalization (SUCRA = 77.9%), while EIN had the highest probability of reducing feeding-related complication rates (SUCRA = 81.0%).

Conclusion

The available evidence suggests that all four models of nutrition support affect the nutritional status and clinical outcomes of critically ill patients in the ICU to varying degrees. However, EN + PN appears to be the most effective approach in improving clinical outcomes and nutrition support in critically ill ICU patients. More high-quality studies are needed to validate these findings.