Efficacy of volume-based feeding (VBF) protocol on critically ill patients: A meta-analysis and systematic review.

BACKGROUND AND OBJECTIVES We aim to evaluate the efficacy and safety of VBF on critically ill patients. METHODS AND STUDY DESIGN We systematically retrieved the related literature from January 1, 2000, to March 30, 2021, sources include MEDLINE, Wed of Science, Cochrane Library and China National Knowledge Infrastructure. Randomized controlled trials or cohort studies of enteral nutrition based on VBF versus rate-based feeding (RBF) in critically illness of adult participants were selected. RESULTS After screening, seven studies involving 691 patients were finally included. Six of them were high quality. The percentage of goal energy received in the VBF group was significantly high-er than that in the RBF group [MD=9.11, 95% CI (5.82, 12.41), p<0.001]. ICU length of stay in the VBF group [MD=-0.8, 95% CI (-1.59, -0.01), p=0.05], mechanical ventilation length [MD=- 1.27, 95% CI (-2.04, -0.51), p=0.001] were significantly shorter in the VBF group, but hospital length of stay [MD=0.62, 95% CI (-4.46, 5.69), p=0.81] was not significantly different. Our study shows that VBF has some non-significant advantages in reducing mortality [RR=0.70, 95% CI (0.44, 1.11), p=0.13]. The rates of adverse reactions, such as diarrhea RR=1.17, 95% CI (0.91, 1.50), p=0.23), emesis (RR=0.80, 95% CI (0.42, 1.55), p=0.51), feeding intolerance [RR=0.97, 95% CI (0.64, 1.48), p=0.90) were not significantly different between the two groups. CONCLUSIONS The VBF protocol significantly improves the successive rate of enteral nutrition in critically ill patients.