Xinrong Chen1, Yanjie Hu1, Xingzhu Yuan1, Jie Yang2. 1. West China School of Nursing/West China Hospital, Sichuan University, Chengdu, Sichuan, China. 2. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Abstract
BACKGROUND/ OBJECTIVES: Whether to conduct early enteral nutrition combined with probiotics (EEN/probiotics) in stroke patients remains controversial. This study was aimed to systematically explore the efficacy and safety of EEN/probiotics in stroke patients. SUBJECT/ METHODS: We performed searches in EMBASE, PubMed, Medline, Cochrane Library, Chinese Biomedicine Literature Database (SinoMed), Chinese Scientific Journal Database (VIP), Chinese National Knowledge Infrastructure (CNKI) and Wanfang database. RESULTS: A total of 26 randomized controlled trials (2216 patients) were included. Meta-analysis showed a significantly lower incidence of gastrointestinal complications (%) (OR, 0.29; 95% CI,0.24-0.36; P < 0.00001), a lower incidence of infection (%) (OR, 0.27; 95% CI, 0.21-0.36; P < 0.00001), a shorter length of hospital stay (d) (MD, -8.70; 95% CI, -13.24 to -4.16; P = 0.003), and a lower dysbacteriosis rate (%) (OR, 0.17; 95% CI, 0.07-0.41; P < 0.0001) in the EEN/probiotics group than EEN group. Compared with EEN group, EEN/probiotics group had lower levels of diamine oxidase (U/L) (MD, -0.78; 95% CI, -0.93 to -0.63; P < 0.00001), D-lactic acid (mmol/L) (MD, -0.06; 95% CI, -0.07 to -0.05; P < 0.00001) and higher levels of albumin (g/L) (MD, 3.38; 95% CI, 2.74-4.02; P < 0.00001), prealbumin (mg/L) (MD, 32.20; 95% CI, 24.42-39.98; P < 0.00001), total protein (g/L) (MD, 4.91; 95% CI, 3.20-6.62; P < 0.00001), hemoglobin (g/L) (MD, 9.62; 95% CI, 7.92-11.32; P < 0.00001), immunoglobulin A (g/L) (MD, 0.23; 95% CI, 0.12-0.34; P < 0.0001) and immunoglobulin G (g/L) (MD, 0.33; 95% CI, 0.21-0.45; P < 0.00001). CONCLUSION: Early enteral nutrition combined with probiotics may effectively improve the nutritional status of stroke patients, regulate the intestinal flora and intestinal mucosal barrier function, improve the immune function, reduce the incidence of infectious complications and gastrointestinal motility disorders.
BACKGROUND/ OBJECTIVES: Whether to conduct early enteral nutrition combined with probiotics (EEN/probiotics) in stroke patients remains controversial. This study was aimed to systematically explore the efficacy and safety of EEN/probiotics in stroke patients. SUBJECT/ METHODS: We performed searches in EMBASE, PubMed, Medline, Cochrane Library, Chinese Biomedicine Literature Database (SinoMed), Chinese Scientific Journal Database (VIP), Chinese National Knowledge Infrastructure (CNKI) and Wanfang database. RESULTS: A total of 26 randomized controlled trials (2216 patients) were included. Meta-analysis showed a significantly lower incidence of gastrointestinal complications (%) (OR, 0.29; 95% CI,0.24-0.36; P < 0.00001), a lower incidence of infection (%) (OR, 0.27; 95% CI, 0.21-0.36; P < 0.00001), a shorter length of hospital stay (d) (MD, -8.70; 95% CI, -13.24 to -4.16; P = 0.003), and a lower dysbacteriosis rate (%) (OR, 0.17; 95% CI, 0.07-0.41; P < 0.0001) in the EEN/probiotics group than EEN group. Compared with EEN group, EEN/probiotics group had lower levels of diamine oxidase (U/L) (MD, -0.78; 95% CI, -0.93 to -0.63; P < 0.00001), D-lactic acid (mmol/L) (MD, -0.06; 95% CI, -0.07 to -0.05; P < 0.00001) and higher levels of albumin (g/L) (MD, 3.38; 95% CI, 2.74-4.02; P < 0.00001), prealbumin (mg/L) (MD, 32.20; 95% CI, 24.42-39.98; P < 0.00001), total protein (g/L) (MD, 4.91; 95% CI, 3.20-6.62; P < 0.00001), hemoglobin (g/L) (MD, 9.62; 95% CI, 7.92-11.32; P < 0.00001), immunoglobulin A (g/L) (MD, 0.23; 95% CI, 0.12-0.34; P < 0.0001) and immunoglobulin G (g/L) (MD, 0.33; 95% CI, 0.21-0.45; P < 0.00001). CONCLUSION: Early enteral nutrition combined with probiotics may effectively improve the nutritional status of stroke patients, regulate the intestinal flora and intestinal mucosal barrier function, improve the immune function, reduce the incidence of infectious complications and gastrointestinal motility disorders.
Authors: Bo-Ram Kim; Jongmin Lee; Min Kyun Sohn; Deog Young Kim; Sam-Gyu Lee; Yong-Il Shin; Gyung-Jae Oh; Yang-Soo Lee; Min Cheol Joo; Eun Young Han; Yun-Hee Kim Journal: Ann Rehabil Med Date: 2017-10-31