ArticleClinical nutrition open science2025
Early versus delayed enteral nutrition in critically ill children under 12 years of age: A systematic review and meta-analysis of randomised controlled trials.
Article in Clinical nutrition open science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
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Who cites it
3 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Nutrition protocols improve caloric adequacy in critically Ill children: a systematic review and meta-analysis.Frontiers in pediatrics · 2026Pooled it
- Factors that influence the provision of enteral feeding for critically ill children: a qualitative evidence synthesis.BMC nutrition · 2025Pooled it
- Early versus delayed enteral nutrition in critically ill children under 12 years of age: an economic evaluation.Cost effectiveness and resource allocation : C/E · 2025Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background & aims: Enteral nutrition (EN) is key to reducing malnutrition risk in critically ill children, with timing of EN initiation being an important consideration. This systematic review aimed to assess the effects of early enteral nutrition (EEN) compared to delayed enteral nutrition (DEN) in critically ill children as part of the Global Evidence, Local Adaptation (GELA) project. Methods: We searched PubMed, Embase and two trial registries (January 2000-November 2023) and included randomised controlled trials (RCTs) comparing EEN (typically within 24-48 hours of admission) to DEN (typically >48 hours of admission) in children aged one month to 12 years, and excluding studies in children with severe acute malnutrition, or conditions requiring long-term EN. Guided by Cochrane methods, we conducted random-effects meta-analyses to obtain pooled effect estimates for outcomes selected by the guideline development group, assessed risk of bias using Cochrane's Risk-of-Bias-2 tool and assessed certainty of the evidence using Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Results: Four RCTs randomising 899 children in critical care settings in India, Iran and USA were included. Overall risk of bias was assessed as 'high risk' or 'some concerns' for all outcomes. Low-certainty evidence suggests that EEN may reduce in-hospital mortality (absolute effect (AE) 53 fewer deaths per 1000, 95% CI -85 to -12, I Conclusion: EEN may reduce in-hospital mortality and length of hospital stay in critically ill children, but our confidence in the effect estimates is limited. More high-quality studies comparing EEN to DEN in relation to patient-relevant and clinically important outcomes in paediatric critical illness are needed. Prospective registration: PROSPERO CRD42023487325.
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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.