Semi-Solid Nutrients for Prevention of Enteral Tube Feeding-Related Complications in Japanese Population: A Systematic Review and Meta-Analysis
Department of Clinical Nutrition, Keiju Medical Center, Ishikawa 926-8605, Japan
Department of Medical Nutrition, Graduate School of Human Life Science, Osaka City University, Osaka 558-8585, Japan
Department of Internal Medicine, Ajisu Kyoritsu Hospital, Yamaguchi 754-1277, Japan
Department of Rehabilitation Medicine, Yokohama City University Medical Center, Kanagawa 232-0024, Japan
Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Aichi 480-1195, Japan
Department of Rehabilitation Medicine, Setagaya Memorial Hospital, Tokyo 158-0092, Japan
Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Mie 5148507, Japan
Author to whom correspondence should be addressed.
Nutrients 2020, 12(6), 1687; https://doi.org/10.3390/nu12061687
Received: 26 April 2020 / Revised: 2 June 2020 / Accepted: 3 June 2020 / Published: 5 June 2020
(This article belongs to the Special Issue Advances in Enteral Nutrition)
The aim of this systematic review was to assess the best available evidence on semi-solid nutrients for prevention of complications associated with enteral tube feeding (ETF). PubMed (MEDLINE), EMBASE, Cochrane Central Register of Controlled Trial, Ichushi-web, and World Health Organization International Clinical Trials Registry Platform databases were searched for relevant articles. Randomized controlled trials (RCTs), cluster RCTs, and crossover trials comparing the effects of semi-solid nutrients with those of control interventions in patients on ETF were included in the review. The primary outcome was development of gastroesophageal reflux (GER). Eight RCTs and five crossover trials involving 889 study participants in total were examined via meta-analysis. The meta-analysis showed that semi-solid nutrients significantly decreased the risk of GER (risk ratio 0.39; 95% confidence interval (CI) 0.21 to 0.73) and the GER index (mean difference −2.93; 95% CI −5.18 to −0.68). Dwell time in the stomach was significantly shortened (standardized mean difference (SMD) −0.50; 95% CI −0.99 to −0.02), as was care time defined as the time needed to prepare and administer the nutrient solution (SMD −8.02; 95% CI −10.94 to −5.10). Semi-solid nutrients significantly decrease the risk of GER and the dwell time in the stomach in adult patients.