Effect of Intra-Abdominal Pressure Monitoring on Enteral Nutrition Complications in Critically Ill Patients: A Meta-Analysis

Abstract

Objective: To systematically evaluate the effect of intra-abdominal pressure monitoring on enteral nutrition complications in critically ill patients. Methods: Literatures concerning the effect of intra-abdominal pressure monitoring on enteral nutritional complications in critically ill patients were searched in these databases, including PubMed, Web of Science, EMbase, Cochrane library, CNKI, WanFang, CBM and VIP from inception to 31 September 2019. Meta analysis was performed by using RevMan 5.3 software. Results: A total of 10 randomized controlled trials were included. Meta-analysis results showed that intra-abdominal pressure monitoring can reduce diarrhea (RR = 0.53, 95% CI: 0.42~0.66, P < 0.01), abdominal distension ( RR = 0.38, 95% CI: 0.26~0.57, P < 0.01), vomiting ( RR = 0.44, 95% CI: 0.33~0.59, P < 0.01), bowel sounds decreased or disappeared ( RR = 0.52, 95% CI: 0.34~0.80, P < 0.01), gastrointestinal bleeding ( RR = 0.60, 95% CI: 0.39~0.92, P = 0.02), reduce the length of hospital stay ( MD = −4.88, 95% CI: −7.08~−2.69, P < 0.01), mechanical ventilation time ( MD = −2.77, 95% CI: −4.44~−1.10, P < 0.01), APACHE-II score ( MD = −5.08, 95% CI: −7.44~−2.71, P < 0.01). Conclusion: Existing evidence shows that intra-abdominal pressure monitoring can help reduce diarrhea, abdominal distention, vomiting, bowel sounds decreased or disappeared, and gastrointestinal bleeding in critically ill patients. Length of hospital stay, mechanical ventilation time, and APACHE-II score were reduced in critically ill patients, but more high-quality studies are needed to corroborate the findings.