ArticleOxidative medicine and cellular longevity2020
Early Enteral Nutrition Preserves Intestinal Barrier Function through Reducing the Formation of Neutrophil Extracellular Traps (NETs) in Critically Ill Surgical Patients.
Article in Oxidative medicine and cellular longevity, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Influence of early enteral nutrition on mortality of adult patients with sepsis: a meta-analysis of randomized controlled trials.European journal of medical research · 2025Pooled it
- Systematic evaluation of risk prediction models for feeding intolerance in ICU patients during enteral nutrition.Asia Pacific journal of clinical nutrition · 2025Pooled it
- Factors associated with acute mesenteric ischemia among critically ill ventilated patients with shock: a post hoc analysis of the NUTRIREA2 trial.Intensive care medicine · 2022Trial
- Integrating gut‑brain axis insights into bundled nutrition care for critically ill patients: From mechanisms to implementation (Review).Molecular medicine reports · 2026Review
- Ethanol, acetaldehyde, lipopolysaccharide, and neutrophil extracellular traps: four-pronged attack on gut epithelial barrier in alcohol use disorder.Anatomical record (Hoboken, N.J. : 2007) · 2026Review
- Gut‑brain axis in anesthesia and critical illness: Molecular crosstalk and its impact on delirium and outcome (Review).International journal of molecular medicine · 2026Review
- Beyond Early Initiation: Predictors of Successful Early Enteral Nutrition Advancement in Critically Ill Patients.Nutrients · 2026Article
- Continuous extracorporeal chyme reinfusion using the veraflo system in open abdomen with duodenostomy: a case report.BMC surgery · 2026Article
- Interruptions of enteral nutrition in intensive care units: mechanisms, clinical impacts, and precision nursing interventions-a scoping review.Frontiers in nutrition · 2026Review
- Achieving ≥70% of energy requirements during early enteral nutrition and short-term inflammatory-metabolic profiles in critically ill patients with sepsis: a prospective cohort study.Frontiers in nutrition · 2026Article
- Intensive care unit-acquired muscle atrophy and weakness in critical illness: a review of long-term recovery strategies.Acute and critical care · 2025Article
- Safety of early feeding after endoscopic ultrasound-guided fine needle biopsy: a retrospective study.BMC gastroenterology · 2025Article
- Review
- A new insight: crosstalk between neutrophil extracellular traps and the gut-liver axis for nonalcoholic fatty liver disease.Frontiers in immunology · 2025Review
- Exploring Global Research Trends in Enteral Nutrition for Mechanically Ventilated Patients: A Comprehensive Bibliometric Study.Journal of multidisciplinary healthcare · 2025Review
- Trophic Nutrition in ICU Patients Undergoing High-Flow Oxygen Therapy and/or Noninvasive Mechanical Ventilation: The Nutri-Trophic Study.Nutrients · 2024Observational
- Early Enteral Nutrition Could Be Associated with Improved Survival Outcome in Cardiac Arrest.Emergency medicine international · 2024Article
- Integrative analysis reveals marker genes for intestinal mucosa barrier repairing in clinical patients.iScience · 2023Article
- Early oral feeding following intestinal anastomosis surgery in infants: a multicenter real world study.Frontiers in nutrition · 2023Article
- The emerging role of neutrophilic extracellular traps in intestinal disease.Gut pathogens · 2022Review
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe gut was suggested as the driver of critical illness and organ injury. Recently, excessive formation of neutrophil extracellular traps (NETs) was associated with mucosal inflammation. Direct investigation of intestinal mucosa is essential to illuminate the potential mechanism of gut barrier in critically ill patients. We hypothesized that early enteral nutrition (EN) could decrease intestinal NETs and maintain the gut barrier.
methodsIntestinal biopsies were obtained using biopsy forceps from critically ill surgical patients complicated with enterocutaneous fistula. Expressions of tight junction (TJ) proteins, mucosal inflammation, and apoptosis were evaluated. Moreover, NET-associated proteins were evaluated in intestinal specimens of patients by Western blot and immunofluorescence analysis.
resultsThe intestinal barrier was significantly impaired in critically ill patients receiving early total parenteral nutrition (TPN), evidenced by intestinal villi atrophy, inflammatory infiltration, increased enterocyte apoptosis, and abnormal TJ expressions. Early EN significantly alleviated these intestinal injuries. In addition, we observed increased formation of the NET structure and elevated expressions of NET-associated proteins in intestines of critically ill surgical patients. Early EN was associated with the diminished presence of NETs and reduced expression of NET-associated proteins. Mechanically, analysis of the TLR4 pathway showed a significant increase in TLR4, NF
conclusionThe intestinal barrier is disrupted in the human gut during critical illness. Our data suggests that an increased NET structure was showed in the gut of critically ill surgical patients, and early EN treatment was associated with the reduction of NET formation and the preservation of mucosal immunity.
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