Enteral, parenteral nutrition and their combination for adults in the intensive care unit
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What is this? Some patients with COVID-19 will become critically ill and need treatment in an intensive care unit (ICU). This may interrupt their feeding routines and reduce appetite or increase nausea and vomiting, leading to malnutrition. Methods of delivery of nutritional requirements include enteral nutrition (EN) and parenteral nutrition (PN), or a combination of both. In this Cochrane systematic review, the authors searched for randomized trials and quasi-randomized trials comparing EN, PN and the combination in adult ICU patients. They did not restrict by language of publication and conducted searches in October 2017. They included 23 randomized trials and two quasi-randomized trials. A further 11 studies are currently awaiting assessment. What works: There is low certainty evidence that enteral nutrition may reduce sepsis, based on studies among people with a range of different conditions. Fewer participants vomited if they had parenteral feeding rather than enteral feeding, but the certainty of the evidence is very low.