Jiang, Wenfang and Pan, Weibang and Cai, Tianbin and Lee, Zhengyii and Lv, Guangyu and Bai, Yingqiao and Liu, Meiqiong and Zhang, Zixiong and Stoppe, Christian and Patel, Jayshil and Ke, Lu and Mao, Wenjian and Wang, Xiaoyuan and CCCNTG, - (2025) Association between early enteral nutrition and clinical outcomes among critically ill patients with circulatory shock: A secondary analysis of a large-scale randomized controlled trial. Clinical Nutrition, 46. pp. 147-154. ISSN 0261-5614, DOI https://doi.org/10.1016/j.clnu.2025.01.029.
Full text not available from this repository.Abstract
Background: It remains unclear if early enteral nutrition benefits patients with circulatory shock, particularly in those with prolonged use of vasopressors. This study aimed to assess the association between early enteral nutrition and clinical outcomes in patients with circulatory shock and whether the duration of circulatory shock (transient or persistent) impacts this association. Methods: Using data from a multicenter, cluster-randomized controlled trial, this secondary analysis involved patients with baseline circulatory shock as defined by a cardiovascular Sequential Organ Failure Assessment score of two or more. Patients were dichotomized into transient or persistent circulatory shock depending on the duration, while transient circulatory shock was defined by the resolution of shock within the first day of enrollment. Early enteral nutrition was defined as the initiation of enteral nutrition within 48 h after intensive care unit admission. The association between early enteral nutrition and a composite outcome (presence of any organ failure on study day 10 or 28-day mortality) was investigated by multivariable and propensity-score-weighted multivariable logistic regression analyses. Results: Seven hundred and eighty-five patients were included in the analysis, and early enteral nutrition was administered to 385 patients (49.0 %) in the whole study cohort. In patients with transient circulatory shock (n = 527), 221 patients (41.9 %) received early enteral nutrition, and in those with persistent circulatory shock (n = 258),164 patients (63.6 %) did so. For the overall cohort, there was no difference in the incidence of primary composite outcome between early enteral nutrition and `no early enteral nutrition ` groups (adjusted odd ratio 0.84, 95 % confidence interval 0.60-1.18) after adjustment for potential confounders. In patients with transient circulatory shock, receipt of early enteral nutrition, compared to no early enteral nutrition, was significantly associated with reduced incidence of the composite outcome (adjusted odd ratio 0.63, 95 % confidence interval 0.41-0.95, p = 0.027). On the contrary, there is no association between early enteral nutrition and the incidence of the composite outcome in patients with persistent circulatory shock (adjusted odd ratio 1.28, 95 % confidence interval 0.64-2.58, p = 0.485). The results of propensity-weighted multivariable analysis conform to the primary analysis.
| Item Type: | Article |
|---|---|
| Funders: | National Natural Science Foundation of China (NSFC) (82070665) |
| Uncontrolled Keywords: | Early enteral nutrition; Critical illness; Circulatory shock; Mortality; Organ failure |
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Faculty of Medicine > Anaesthesiology Department |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 29 Apr 2025 08:04 |
| Last Modified: | 29 Apr 2025 08:04 |
| URI: | http://eprints.um.edu.my/id/eprint/47901 |
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