Analysis of outcome indicators in clinical trials related to feeding intolerance in ICU patients receiving enteral nutrition feeding

Purpose: The aim of this study was to analyze the outcome indicators of clinical trials related to feeding intolerance in patients receiving enteral nutrition feeding in ICUs published in the past 10?years, and to provide data support for the construction of a core outcome set for clinical trials on feeding intolerance in ICU patients.

Methods: The databases of Cochrane Library, Pubmed, Embase, SinoMed, Wanfang Data and China Knowledge Network (CNKI) were searched using a combination of free and subject terms. The time limit was from January 2013 to September 2023. Literature screening and data extraction were carried out independently by two researchers strictly according to the inclusion and exclusion criteria, and in case of disagreement, the decision was discussed by a third party.

Results: A total of 52 papers reporting 138 different outcome indicators were included in this study. Indicators were categorized into 8 domains based on their functional characteristics. In descending order of frequency of reporting, they were symptoms and signs (82.7%), physical and chemical tests (75%), indicators related to nutritional support (63.5%), safety events (59.6%), long-term prognosis (34.6%), economic assessment (21.2%), functional status (5.8%), and satisfaction (3.8%). The top 10 most frequently reported outcome indicators were diarrhea, vomiting, bloating, gastric remnants, reflux, aspiration, gastric retention, mortality, albumin and constipation. The main problems with the indicators included a lack of systematicity, clinical utility, and standardization of reporting, as well as inconsistency in the time point of measurement and misuse of the indicators.

Conclusion: The lack of core outcome sets had led to significant variability and non-standardization in the outcome indicators reported by Enteral Feeding Intolerance clinical studies. Enteral Feeding Intolerance is an important factor affecting the prognosis of critically ill patients, and the outcome indicators of its clinical studies need to be standardized. It is recommended that a core outcome set for Enteral Feeding Intolerance be constructed to standardize the reporting of outcome indicators in future studies, reduce inter-study heterogeneity, and improve the utility of study results and the quality of clinical decision-making.

Contributors

Chaokai He, Xiaorong Li, Fan Li, Ying Xia, Ying Xia, Kunrong Yu

Publication

Journal: Frontiers in Nutrition
Volume: 12
Issue:
Pages: -
Year: 2025
DOI: 10.3389/fnut.2025.1666339

Further Study Information

Current Stage: Completed
Date:
Funding source(s): The author(s) declare that financial support was received for the research and/or publication of this article. This work was funded by grant No. 2022-PUMCH-A-244 from the National High Level Hospital Clinical Research Funding, China and grant No. CIFMS 2021-I2M-1-048 from the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences, China.


Health Area

Disease Category: Other

Disease Name: Critical care

Target Population

Age Range: 18 - 88

Sex: Either

Nature of Intervention: Diet and nutrition

Stakeholders Involved

Study Type

- Systematic review of outcomes measured in trials

Method(s)

- Systematic review

The databases of Cochrane Library, Pubmed, Embase, SinoMed, Wanfang Data and China Knowledge Network (CNKI) were searched using a
combination of free and subject terms. The time limit was from January 2013 to September 2023. Literature screening and data extraction were carried
out independently by two researchers strictly according to the inclusion and exclusion criteria, and in case of disagreement, the decision was discussed by a third party.