Evidence map›Paper›PMID 35464756›Full record

ArticleCritical care explorations2022

Role of Early Enteral Nutrition in Mechanically Ventilated COVID-19 Patients.

Krista Haines, Virginia Parker, Tetsu Ohnuma, Vijay Krishnamoorthy, Karthik Raghunathan, Suela Sulo, Kirk W Kerr, Beth Y Besecker, Bridget A Cassady, Paul E Wischmeyer

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Critical care explorations, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.7field-weighted citation impact, top 18% 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

9 citing papers in PubMed, 16 citations in OpenAlex.

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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

10 authors at 4 institutions in 1 country.

Krista HainesDivision of Trauma and Critical Care and Acute Care Surgery, Department of Surgery, Duke University Medical Center, Durham, NC.
Virginia ParkerDivision of Trauma and Critical Care and Acute Care Surgery, Department of Surgery, Duke University Medical Center, Durham, NC.
Tetsu OhnumaThe Critical Care and Perioperative Epidemiologic Research (CAPER) Unit, Duke University Medical Center, Durham, NC.
Vijay KrishnamoorthyThe Critical Care and Perioperative Epidemiologic Research (CAPER) Unit, Duke University Medical Center, Durham, NC.
Karthik RaghunathanThe Critical Care and Perioperative Epidemiologic Research (CAPER) Unit, Duke University Medical Center, Durham, NC.
Suela SuloScientific and Medical Affairs, Abbott Nutrition, Columbus, OH.
Kirk W KerrScientific and Medical Affairs, Abbott Nutrition, Columbus, OH.
Beth Y BeseckerScientific and Medical Affairs, Abbott Nutrition, Columbus, OH.
Bridget A CassadyScientific and Medical Affairs, Abbott Nutrition, Columbus, OH.
Paul E WischmeyerDepartment of Anesthesiology, Duke University Medical Center, Durham, NC.
Duke Medical Center · USAbbott Nutrition (United States)Abbott (United States) · USDuke University Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Current guidance recommends initiation of early enteral nutrition (early EN) within 24-36 hours of ICU admission in critically ill COVID-19 patients. Despite this recommendation, there is quite limited evidence describing the effect of early EN on outcomes in COVID-19 patients. The association between early EN (within 3 d post intubation) and clinical outcomes in adult COVID-19 patients requiring mechanical ventilation (within 2 d post ICU admission) was evaluated.

designWe performed a nationwide observational cohort study using a nationwide administrative-financial database (Premier) in United States.

settingInformation pertaining to all COVID-19 patients admitted to ICU from 75 hospitals between April and December 2020 was analyzed. PATIENTS: A total of 861 COVID-19 patients were included.

interventionsNone. MEASUREMENTS AND MAIN

resultsClinical outcomes were assessed via regression models to control for patient and hospital characteristics. We identified 513 COVID-19 ICU patients (59.2%) requiring mechanical ventilation who received early EN and had similar baseline characteristics to late EN group. Compared with late EN group, the early EN group had shorter ICU (hazard ratio [HR], 1.39; 95% CI, 1.15-1.68) and hospital length of stays (LOS) (HR, 1.53; 95% CI, 1.23-1.91), fewer mechanical ventilation days (HR, 1.25; 95% CI, 1.01-1.54), and lower cost (-$22,443; 95% CI, -$32,342 to -$12,534). All comparisons were statistically significant (

conclusionsIn patients with COVID-19 requiring mechanical ventilation, early EN is associated with earlier liberation from mechanical ventilation, shorter ICU and hospital LOS, and decreased cost. Our results are among the first to support guideline recommendations for initiation of early EN in COVID-19 ICU patients. Further, our data show nearly 40% of critically ill COVID-19 patients fail to have early EN initiated, even at 3 d post initiation of mechanical ventilation. These results emphasize the need for targeted strategies promoting initiation of early EN, as this may lead to improved clinical and economic outcomes in severe COVID-19 patients.

Indexed as

COVID-19critical illnessintensive care unitnutritionpatient outcomessevere acute respiratory syndrome coronavirus 2

Identifiers

PMID35464756
PMCPMC9018995
OpenAlexW4223997641

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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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.