The effect of intermittent versus continuous enteral feeding for critically ill patients: a meta-analysis of randomized controlled trials

ObjectivesThe appropriate strategy for enteral feeding in critically ill patients still remains controversial. Therefore, we conducted this meta-analysis to compare the effect of intermittent versus continuous enteral feeding method for critically ill patients.MethodsElectronic databases including PubMed, Embase, Scopus, and Cochrane Library were searched up to April 10th, 2023 for randomized controlled trials evaluating the effect of intermittent versus continuous enteral feeding for critically ill patients. The primary outcomes were feeding intolerances, including diarrhea, vomiting, distension, constipation, gastric retention, and aspiration pneumonia. The secondary outcomes were mortality in intensive care unit (ICU), length of stay in ICU, and achievement of nutritional goal.ResultsThirteen studies with a total of 884 patients were analyzed in this meta-analysis. Overall, the use of intermittent enteral feeding was associated with higher incidence of diarrhea (OR 1.66, 95%CI 1.13 to 2.43, I2 = 16%) and distension (OR 2.29, 95%CI 1.16 to 4.51, I2 = 0%), lower incidence of constipation (OR 0.58, 95%CI 0.37 to 0.90, I2 = 0%), and longer length of ICU stay (MD 1.09, 95%CI 0.53 to 1.64, I2 = 0%). Moreover, no significant difference was identified for other outcome measures.ConclusionIn critically ill patients, the implementation of intermittent enteral feeding was associated with higher incidence of diarrhea and distension, longer length of ICU stay, but lower occurrence of constipation. Nevertheless, the absence of sufficient high-quality randomized controlled clinical trials precludes any definitive conclusions regarding the optimal approach to enteral feeding in this population. There is an imperative need for more studies to further assess the efficacy of the two enteral feeding strategies

Changes in char structure due to inorganic matters during anthracite pyrolysis

© 2017 Elsevier B.V. To understand effects of inherent mineral matters on the evolution of char structure, the microcrystalline structures of chars from the pyrolysis of raw, HCl-washed (CW) and HCl & HF-washed anthracites (CFW) were investigated by X-ray diffraction (XRD) respectively. Stacking height (Lc), interlayer spacing (d 002 ) and crystallite width (La) were used as parameters for char structure estimation. The results showed that with increasing contents of inherent mineral matters, Lc of char decreased, whereas d 002 and La increased. To study effects of a single inorganic matter, CFW was impregnated with Al 2 O 3 , SiO 2 , and CaO respectively. It was found that all of them (oxides) have resulted in the decrease in Lc and increase in La and d 002 . Differing from Al 2 O 3 , SiO 2 , and CaO, the introduction of Fe 2 O 3 has caused the reduction for both La and Lc values simultaneously, especially when the Fe 2 O 3 contents in the coal were high