Evidence map›Paper›PMID 39511681›Full record

SynthesisCritical care (London, England)2024

The efficacy of fiber-supplemented enteral nutrition in critically ill patients: a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis.

Jana Larissa Koch, Charles Chin Han Lew, Felix Kork, Alexander Koch, Christian Stoppe, Daren K Heyland, Ellen Dresen, Zheng-Yii Lee, Aileen Hill

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Critical care (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07719673 (Enteral Nutrition to Enhance Colonization Resistance Through Gut Microbiota Modulation in Critically Ill Patients), which is not on this map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
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.

NCT07719673 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Enteral Nutrition to Enhance Colonization Resistance Through Gut Microbiota Modulation in Critically Ill Patients: A Randomized Controlled Pilot Trial

TypeinterventionalSponsorIuliu Hatieganu University of Medicine and PharmacyRan2026 to 2027Enrolled60ConditionsBacterial Colonization, Multidrug Resistant Organisms, Critical Illness, Gut Microbiota DysbiosisArmsFibre-Enriched Enteral Nutrition, Standard Enteral Nutrition
3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

  1. Review
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  4. Article
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  6. Review
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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

9 authors.

Jana Larissa KochMedical Faculty, RWTH Aachen University, Aachen, Germany.
Charles Chin Han LewDepartment of Dietetics and Nutrition, Ng Teng Fong General Hospital, Singapore, Singapore.
Felix KorkDepartment of Anaesthesiology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
Alexander KochDepartment of Gastroenterology, Metabolic Diseases and Internal Intensive Care Medicine, University Hospital RWTH Aachen, Aachen, Germany.
Christian StoppeDepartment of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Würzburg, Germany.
Daren K HeylandDepartment of Critical Care Medicine, Queen's University, Kingston, ON, Canada.
Ellen DresenDepartment of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Würzburg, Germany.
Zheng-Yii Lee *Department of Cardiac Anaesthesiology and Intensive Care Medicine, Charité Berlin, Berlin, Germany.
Aileen Hill *Department of Anaesthesiology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany. ahill@ukaachen.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEvidence on the benefits of fiber-supplemented enteral nutrition (EN) in critically ill patients is inconsistent, and critical care nutrition guidelines lack recommendations based on high-quality evidence. This systematic review and meta-analysis (SRMA) aims to provide a current synthesis of the literature on this topic.

methodsFor this SRMA of randomized controlled trials (RCT), electronic databases (MEDLINE, EMBASE, CENTRAL) were searched systematically from inception to January 2024 and updated in June 2024. Trials investigating clinical effects of fiber-supplemented EN versus placebo or usual care in adult critically ill patients were selected. Two independent reviewers extracted data and assessed the risk of bias of the included studies. Random-effect meta-analysis and trial sequential analysis (TSA) were conducted. The primary outcome was overall mortality, and one of the secondary outcomes was diarrhea incidence. Subgroup analyses were also performed for both outcomes.

resultsTwenty studies with 1405 critically ill patients were included. In conventional meta-analysis, fiber-supplemented EN was associated with a significant reduction of overall mortality (RR 0.66, 95% CI 0.47, 0.92, p = 0.01, I

conclusionVery low-certainty evidence suggests that fiber-supplemented EN has clinical benefits. High-quality multicenter RCTs with large sample sizes are needed to substantiate any firm recommendation for its routine use in this group of patients. PROSPERO registration number: CRD42023492829.

Indexed as

Critical IllnessDietary FiberEnteral NutritionDietary SupplementsHumansRandomized Controlled Trials as TopicDietary FiberCritical careEnteral nutritionFiberMedical nutrition therapyMeta-analysisSystematic reviewTrial sequential analysis

Identifiers

PMID39511681
PMCPMC11545523

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Registered trials

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.