Timing of (supplemental) parenteral nutrition in critically ill patients: a systematic review

Annals of Intensive Care

Table 9 Remaining secondary end points in included studies and results for EPN, LPN and EN groups

Outcome	Study		Study arms			Significance of results
Outcome	Study		EPN	LPN	EN	Significance of results
Mechanical ventilation	Bauer 2000 [11]	Mean days	11 ± 9	x	10 ± 8	no p-value, ns
	Casaer 2011 [13]	Median days	2	2	x	p = 0.02
	Casaer 2011 [13]	Duration >2 days	40.2%	36.3%	x	p = 0.006; in LPN 9.7% relative reduction in mechanical ventilation in patients requiring ≥2 days mechanical ventilation
	Doig 2013 [14]		NR	x	NR	EPN: 1.07 fewer days than standard care.
	Doig 2013 [14]	Mean days per 10 patients x ICU days	7.73	x	7.26	MD −0.47; 95% CI −0.82 to −0.11; p = 0.01)
	Heidegger 2013 [15]	Mean hours (95% CI)	x	153 (126 to 178)	166 (138 to 189)	p = 0,2912
	Cahill 2011 [12]	Median days	8.8	18.2	9.3	p < 0.001^†
	Kutsogiannis 2011 [16]	Median days	9.1	14.5	8.4	p = 0.007^
Hypoglycaemia	Bauer 2000 [11]	Mean glucose in grams per liter at day 7 (±SD)	1.16 ± 0.56	x	1.31 ± 0.62	p < 0.05
	Casaer 2011 [13]	Number of patients (%)	45 (1.9)	81 (3.5)	x	p = 0.001
	Heidegger 2013 [15]	NR	x	NR	NR	No difference between EN + LPN vs EN
Duration of RRT	Bauer 2000 [11]	Mean days (±SD)	0.8 (±2.4)	x	0.9 (±2.3)	No p-value, ns
	Casaer 2011 [13]	Median days	10	7	x	p =0.008
	Heidegger 2013 [15]		x	NR	NR	No difference between EN + LPN vs EN
Body composition (score increase/week)	Doig 2013 [14]	Increased SGA score/week	0.43	x	0.27	MD −0.16; 95% CI −0.28 to −0.038; p = 0.01
Body composition (score increase/week)	Doig 2013 [14]	Increased SGA score/week	0.44	x	0.31	MD −0.13; 95% CI −0.25 to −0.01; p = 0.04

EPN, early parenteral nutrition; LPN, late parenteral nutrition; EN, enteral nutrition; x, not applicable; p, p-value; ns, nonsignificant; NR, not reported; ICU, intensive care unit; MD, mean difference; 95% CI, 95% confidence interval; vs, versus; RRT, renal replacement therapy; SD, standard deviation; SGA, Subjective Global Assessment. NB: studies used different definitions for EPN, LPN and EN. ^†, comparing EPN versus EN and comparing LPN versus EN. ^, comparing EN versus LPN.