SynthesisFrontiers in nutrition2026
Diagnostic accuracy of gastrointestinal ultrasound in predicting enteral feeding intolerance: a systematic review and meta-analysis.
Synthesis in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
5 authors.
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Abstract
Background: Gastrointestinal ultrasonography (GI-US) has significant potential for predicting enteral nutrition intolerance (ENFI) in critically ill adults. However, current evidence is fragmented, with substantial variability in predictors, diagnostic thresholds, acquisition protocols, and a lack of cross-indicator comparisons. These inconsistencies hinder evidence synthesis and the standardization of clinical practice. Objective: This study aimed to systematically synthesize and evaluate the diagnostic performance of GI-US predictors for ENFI, identifying core predictors that balance accuracy with clinical feasibility. Methods: Comprehensive searches were conducted in PubMed, Web of Science, Embase, CINAHL, the Cochrane Library, CNKI, Wanfang, and SinoMed through September 12, 2024. Two independent reviewers screened studies, extracted data, and assessed quality using the QUADAS-2 tool. Diagnostic accuracy was analyzed using a bivariate random-effects model to generate summary estimates of sensitivity, specificity, likelihood ratios, diagnostic odds ratios, and SROC-AUCs, all with 95% confidence and prediction intervals. Threshold effects, heterogeneity, sensitivity analyses, publication bias (via Deeks' test), and clinical utility (via Fagan nomograms) were comprehensively evaluated. Results: The analysis included 16 studies with 1,261 participants, evaluating ten single predictors, one composite score, and two multivariable models. Seven studies ( Conclusion: Current GI-US predictors can be categorized into gastric, intestinal, and superior mesenteric artery parameters. GCSA is supported by strong evidence for quantitative synthesis, demonstrating reliable diagnostic accuracy and bedside feasibility. Other predictors and emerging models show promise but require validation. Large, standardized multicenter studies are needed to validate multidomain predictors, harmonize measurement protocols, and develop integrated frameworks for effective ENFI management. Systematic review registration: PROSPERO, Identifier CRD420251019447.
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