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Enteral versus parenteral nutrition in critically ill patients: an updated systematic review and meta-analysis of randomized controlled trials

Overview of attention for article published in Critical Care, April 2016
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (94th percentile)
  • High Attention Score compared to outputs of the same age and source (95th percentile)

Citations

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203 Dimensions

Readers on

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401 Mendeley
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1 CiteULike
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Title
Enteral versus parenteral nutrition in critically ill patients: an updated systematic review and meta-analysis of randomized controlled trials
Published in
Critical Care, April 2016
DOI 10.1186/s13054-016-1298-1
Pubmed ID
Authors

Gunnar Elke, Arthur R. H. van Zanten, Margot Lemieux, Michele McCall, Khursheed N. Jeejeebhoy, Matthias Kott, Xuran Jiang, Andrew G. Day, Daren K. Heyland

Abstract

Enteral nutrition (EN) is recommended as the preferred route for early nutrition therapy in critically ill adults over parenteral nutrition (PN). A recent large randomized controlled trial (RCT) showed no outcome differences between the two routes. The objective of this systematic review was to evaluate the effect of the route of nutrition (EN versus PN) on clinical outcomes of critically ill patients. An electronic search from 1980 to 2016 was performed identifying relevant RCTs. Individual trial data were abstracted and methodological quality of included trials scored independently by two reviewers. The primary outcome was overall mortality and secondary outcomes included infectious complications, length of stay (LOS) and mechanical ventilation. Subgroup analyses were performed to examine the treatment effect by dissimilar caloric intakes, year of publication and trial methodology. We performed a test of asymmetry to assess for the presence of publication bias. A total of 18 RCTs studying 3347 patients met inclusion criteria. Median methodological score was 7 (range, 2-12). No effect on overall mortality was found (1.04, 95 % CI 0.82, 1.33, P = 0.75, heterogeneity I(2) = 11 %). EN compared to PN was associated with a significant reduction in infectious complications (RR 0.64, 95 % CI 0.48, 0.87, P = 0.004, I(2) = 47 %). This was more pronounced in the subgroup of RCTs where the PN group received significantly more calories (RR 0.55, 95 % CI 0.37, 0.82, P = 0.003, I(2) = 0 %), while no effect was seen in trials where EN and PN groups had a similar caloric intake (RR 0.94, 95 % CI 0.80, 1.10, P = 0.44, I(2) = 0 %; test for subgroup differences, P = 0.003). Year of publication and methodological quality did not influence these findings; however, a publication bias may be present as the test of asymmetry was significant (P = 0.003). EN was associated with significant reduction in ICU LOS (weighted mean difference [WMD] -0.80, 95 % CI -1.23, -0.37, P = 0.0003, I(2) = 0 %) while no significant differences in hospital LOS and mechanical ventilation were observed. In critically ill patients, the use of EN as compared to PN has no effect on overall mortality but decreases infectious complications and ICU LOS. This may be explained by the benefit of reduced macronutrient intake rather than the enteral route itself.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 401 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
France 1 <1%
Brazil 1 <1%
Unknown 399 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 67 17%
Student > Bachelor 46 11%
Researcher 44 11%
Other 38 9%
Student > Postgraduate 31 8%
Other 87 22%
Unknown 88 22%
Readers by discipline Count As %
Medicine and Dentistry 177 44%
Nursing and Health Professions 63 16%
Agricultural and Biological Sciences 13 3%
Biochemistry, Genetics and Molecular Biology 12 3%
Pharmacology, Toxicology and Pharmaceutical Science 11 3%
Other 28 7%
Unknown 97 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 44. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 November 2022.
All research outputs
#784,773
of 22,579,714 outputs
Outputs from Critical Care
#589
of 6,012 outputs
Outputs of similar age
#14,758
of 281,133 outputs
Outputs of similar age from Critical Care
#3
of 42 outputs
Altmetric has tracked 22,579,714 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 96th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,012 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 19.0. This one has done particularly well, scoring higher than 90% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 281,133 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 94% of its contemporaries.
We're also able to compare this research output to 42 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 95% of its contemporaries.