Meta-analysis of effects of early enteral nutrition supplemented with probiotics on clinical outcomes in patients with severe head injury

Abstract:

Objective：To assess the effects of early enteral nutrition supplemented with probiotics on clinical outcomes in patients with severe head injury. Methods：PubMed，Cochrane Central Register of Controlled Trials，China National Knowledge Infrastructure，Wan－fang database，and Chinese Biomedical Literature were electronically searched for the purpose of identifying the randomized controlled trials investigated the potential of early enteral nutrition supplemented with probiotics on patients with severe head injury，as well as the bibliographies of eligible studies and topic-related reviews were manually checked. Two investigators checked citations，extracted data，appraised risk of bias of included studies，and then STATA 12.0 was used to perform meta-analysis. Results：Totally 18 trials enrolling 1 016 patients were included. Meta-analysis indicated that early enteral nutrition supplemented with probiotics was associated with decreased risk of infection（RR=0.53，96%CI=0.44 to 0.65，P=0.000），decreased risk of mortality（RR=0.56，96%CI=0.38 to 0.82，P=0.003），decreased risk of gastrointestinal complications（RR=0.19，96%CI=0.13 to 0.25，P=0.000），and shortened stays in intensive care unit（MD=-4.55，96%CI=-5.91 to -3.19，P=0.000）. Conclusion：Early enteral nutrition supplemented with probiotics effectively decreases the risk of infection，mortality，and gas－trointestinal complications，as well as shortens the stays in ICU，and thus it should be extensively adopted to manage these given patients.