Micronutrient intake from enteral nutrition in critically ill adults: A systematic review of randomised controlled trials

Breik et al., 2022 | Aust Crit Care | Systematic Review

Citation

Breik Lina, Tatucu-Babet Oana A, Ridley Emma J. Micronutrient intake from enteral nutrition in critically ill adults: A systematic review of randomised controlled trials. Aust Crit Care. 2022-Sep;35(5):564-574. doi:10.1016/j.aucc.2021.09.001

Abstract

OBJECTIVES: The primary objective was to compare the intake of important micronutrients provided from enteral nutrition to critically ill patients with the Australia and New Zealand recommended dietary intakes. A secondary objective was to compare the upper levels of intake and investigate prespecified subgroups. REVIEW METHOD USED: A systematic literature review was performed. DATA SOURCES: MEDLINE, EMBASE, CINAHL, and CENTRAL were used. REVIEW METHODS: Databases were searched for randomised controlled trials that investigated an enteral nutrition intervention as the sole source of nutrition, were published in English between January 2000 and January 8th, 2021, and provided data to calculate micronutrient intake. The primary outcome was the % recommended dietary intake. The quality of individual trials was assessed using the Cochrane Risk of Bias Tool. Outcomes are presented as either mean ± standard deviation or median [interquartile range], with a p < 0.05 considered statistically significant. RESULTS: Thirteen trials were included (n = 1538 patients). Trials investigating hypocaloric nutrition were excluded from the primary outcome assessment (conducted in nine trials (n = 1220)). All nine trials delivered ≥104% of the recommended dietary intakes and <100% of the upper level of intakes of all micronutrients. In subgroup analyses, trials with ≥80% target energy delivered a higher % of the recommended dietary intake of vitamin B12, thiamine, zinc, and vitamin C. Acute Physiology and Chronic Health Evaluation scores ≥20 delivered a higher % of the recommended dietary intake of vitamin B12 and vitamin A. Antioxidant formulas compared with standard formulas delivered a higher % recommended dietary intake of vitamin C and thiamine. In the four trials that investigated hypocaloric feeding compared with control, there was no difference in micronutrient intake. The quality was low. CONCLUSIONS: Enteral nutrition delivery frequently met the recommended dietary intakes for all micronutrients investigated and did not exceed the upper levels of intake set for health. PROSPERO REGISTRATION: CRD42020178333.

Key Findings

Thirteen trials were included (n = 1538 patients). Trials investigating hypocaloric nutrition were excluded from the primary outcome assessment (conducted in nine trials (n = 1220)). All nine trials delivered ≥104% of the recommended dietary intakes and <100% of the upper level of intakes of all micronutrients. In subgroup analyses, trials with ≥80% target energy delivered a higher % of the recommended dietary intake of vitamin B12, thiamine, zinc, and vitamin C. Acute Physiology and Chronic Hea

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population the australia and new
Sample Size 1538
Age Range See abstract
Condition See abstract

MeSH Terms

  • Adult
  • Antioxidants
  • Ascorbic Acid
  • Critical Illness
  • Eating
  • Enteral Nutrition
  • Humans
  • Micronutrients
  • Thiamine
  • Vitamin A
  • Vitamin B 12
  • Zinc

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review
  • Vertical: thiamine

Provenance


Source extracted via PubMed E-utilities API on 2026-04-09