Benefits of the early beginning of enteral administration among adult patients: a systematic review
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Abstract
Introduction: The early enteral administration is a therapeutic strategy aimed at critical patients which, if started within the first 24 to 48 hours can reduce the severity and complications of the illness as well as the permanence in the intensive therapy units.
Objective: To identify the benefits which an enteral administration with early initiation has on adult patients in an intensive care unit in comparison to the same therapy but with late initiation.
Methodology: This is a systematic review based on the databases of Medline, CUIDEN, LILACS; Cochrane, and ScienceDirect. AND, OR, NOT, and WITH positional boolean operators, and DeCS and MeSH descriptors such as enteral administration and critical patient were all used. The critical reading was based on the Spanish Critical Appraisal Skills Programme (CASPe), and the NICE and OXFORD scales were used to appraise the evidence.
Results: Out of 100 articles found, 13 were selected for the study: 5 Meta-analyses; 3 systematic reviews; 4 random clinical essays; and 1 prospective cohort study.
Discussion: The most important effects of enteral administration with early initiation were a reduction of the intestinal atrophy and bacterial spreading, a lower probability of developing other infections, including pneumonia, and a lower risk of developing systemic inflammatory response syndrome and multiple organ failure.
Conclusions: Given the absence of contraindications, enteral administration initiated within the first 24 to 48 hours can yield diverse benefits to critical patients. Moreover, it can also attenuate the hypercatabolic status and help improve the overall health of these patients.
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