Evidence map›Paper›PMID 28168570›Full record

GuidelineIntensive care medicine2017

Early enteral nutrition in critically ill patients: ESICM clinical practice guidelines.

Annika Reintam Blaser, Joel Starkopf, Waleed Alhazzani, Mette M Berger, Michael P Casaer, Adam M Deane, Sonja Fruhwald, Michael Hiesmayr, Carole Ichai, Stephan M Jakob and 15 more

Open access · hybridAbstract readComparative StudyMeta-AnalysisPractice Guideline
PubMed Full text at PMC Publisher
In one paragraph

Guideline in Intensive care medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 303 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
303citing papers in PubMed, 15 pooled it
44.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

303 citing papers in PubMed, 15 syntheses or guidelines pooled it, 791 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Guideline
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Pooled it
  13. Pooled it
  14. Pooled it
  15. Monitoring of gastric residual volume during enteral nutrition.The Cochrane database of systematic reviews · 2021
    Pooled it
  16. Trial
  17. Trial
  18. Trial
  19. Enhanced Patient Comfort and Satisfaction with Early Oral Feeding after Thoracoscopic Lung Cancer Resection.Medical science monitor : international medical journal of experimental and clinical research · 2023
    Trial
  20. Trial

243 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors at 18 institutions in 13 countries.

Annika Reintam BlaserDepartment of Anaesthesiology and Intensive Care, University of Tartu, Tartu, Estonia. annika.reintam.blaser@ut.ee.
Joel StarkopfDepartment of Anaesthesiology and Intensive Care, University of Tartu, Tartu, Estonia.
Waleed AlhazzaniDepartment of Medicine, Division of Critical Care, McMaster University, Hamilton, Canada.
Mette M BergerServices of Adult Intensive Care Medicine and Burns, Lausanne University Hospital, Lausanne, Switzerland.
Michael P CasaerDepartment of Intensive Care Medicine, University Hospital Leuven, Louvain, Belgium.
Adam M DeaneDiscipline of Acute Care Medicine, University of Adelaide, Adelaide, Australia.
Sonja FruhwaldDepartment of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria.
Michael HiesmayrKlinische Abteilung für Herz-Thorax-Gefäßchirurgische Anästhesie & Intensivmedizin, Medizinische Universität Wien, Vienna, Austria.
Carole IchaiIntensive Care Unit, Hôpital Pasteur 2, University of Nice, Nice, France.
Stephan M JakobDepartment of Intensive Care Medicine, University Hospital, University of Bern, Bern, Switzerland.
Cecilia I LoudetIntensive Care Unit, Hospital Interzonal General de Agudos General San Martín de La Plata, Buenos Aires, Argentina.
Manu L N G MalbrainIntensive Care Unit, Ziekenhuis Netwerk Antwerpen, ZNA Stuivenberg, Antwerp, Belgium.
Juan C Montejo GonzálezDepartment of Intensive Care Medicine, Hospital Universitario 12 de Octubre, Madrid, Spain.
Catherine Paugam-BurtzAnesthesiology and Perioperative Care Medicine Department, Hôpital Beaujon APHP, Clichy, France.
Martijn PoezeDepartment of Surgery/IntensiveCare Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
Jean-Charles PreiserDepartment of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
Pierre SingerIntensive Care Department, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel.
Arthur R H van ZantenDepartment of Intensive Care Medicine, Gelderse Vallei Hospital, Ede, The Netherlands.
Jan De WaeleDepartment of Critical Care Medicine, Ghent University Hospital, Ghent, Belgium.
Julia WendonDepartment of Intensive Care Medicine, Division of Immunobiology and Transplantation, King's College London, King's College Hospital, London, UK.
Jan WernermanDepartment of Anaesthesiology and Intensive Care Medicine, Karolinska University Hospital Huddinge and Karolinska Institutet, Stockholm, Sweden.
Tony WhitehouseDepartment of Critical Care and Anaesthesia, Queen Elizabeth Hospital, Birmingham, UK.
Alexander WilmerMedical Intensive Care Unit, University Hospital Leuven, Leuven, Belgium.
Heleen M Oudemans-van StraatenDepartment of Intensive Care Medicine, VU University Medical Center, Amsterdam, The Netherlands.
ESICM Working Group on Gastrointestinal Function
Amsterdam UMC Location Vrije Universiteit Amsterdam · NLHôpital Beaujon · FRKarolinska University Hospital · SEMedical University of Graz · ATUniversité Libre de Bruxelles · BEUniversity of Bern · CHUniversity of Lausanne · CHGhent University Hospital · BEHôpital Pasteur · FRHospital Universitario 12 De Octubre · ESKing's College London · GBNational University of General San Martín · ARQueen Elizabeth Hospital Birmingham · GBTartu University Hospital · EETel Aviv University · ILThe University of Adelaide · AUUniversity of Lucerne · CHUniversity of Tartu · EE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo provide evidence-based guidelines for early enteral nutrition (EEN) during critical illness.

methodsWe aimed to compare EEN vs. early parenteral nutrition (PN) and vs. delayed EN. We defined "early" EN as EN started within 48 h independent of type or amount. We listed, a priori, conditions in which EN is often delayed, and performed systematic reviews in 24 such subtopics. If sufficient evidence was available, we performed meta-analyses; if not, we qualitatively summarized the evidence and based our recommendations on expert opinion. We used the GRADE approach for guideline development. The final recommendations were compiled via Delphi rounds.

resultsWe formulated 17 recommendations favouring initiation of EEN and seven recommendations favouring delaying EN. We performed five meta-analyses: in unselected critically ill patients, and specifically in traumatic brain injury, severe acute pancreatitis, gastrointestinal (GI) surgery and abdominal trauma. EEN reduced infectious complications in unselected critically ill patients, in patients with severe acute pancreatitis, and after GI surgery. We did not detect any evidence of superiority for early PN or delayed EN over EEN. All recommendations are weak because of the low quality of evidence, with several based only on expert opinion.

conclusionsWe suggest using EEN in the majority of critically ill under certain precautions. In the absence of evidence, we suggest delaying EN in critically ill patients with uncontrolled shock, uncontrolled hypoxaemia and acidosis, uncontrolled upper GI bleeding, gastric aspirate >500 ml/6 h, bowel ischaemia, bowel obstruction, abdominal compartment syndrome, and high-output fistula without distal feeding access.

Indexed as

Cohort StudiesCritical IllnessEnteral NutritionEvidence-Based MedicineHumansRandomized Controlled Trials as TopicTime FactorsAbdominal problemsContraindicationsDelay of enteral nutritionEarly enteral nutritionGI symptomsParenteral nutrition

Identifiers

PMID28168570
PMCPMC5323492
OpenAlexW2584454916

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.