A meta-analysis of the efficacy of different nasogastric tube feeding modes on early enteral nutrition in critically ill patients

Corresponding author: chenyangbo, chjp88@139.com

DOI: 10.12201/bmr.202604.00178

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  Abstract: Objective: To systematically compare the efficacy of continuous versus intermittent nasogastric tube feeding in delivering early enteral nutrition (EEN) to critically ill patients, and to inform evidence-based selection of feeding strategies in clinical practice. Methods: We searched PubMed, Embase, the Cochrane Library, Web of Science, CNKI, Wanfang Data, and VIP Database from inception to July 2025 for randomized controlled trials (RCTs) comparing continuous and intermittent nasogastric feeding during EEN in adult critically ill patients. Two independent reviewers screened studies, extracted data, and assessed risk of bias using the Cochrane RoB 2 tool. Meta-analyses were performed using RevMan 5.4 and Stata 17.0, with effect estimates presented as mean differences (MD) or odds ratios (OR) and corresponding 95% confidence intervals (CIs); heterogeneity was quantified using I2 statistics. Results: Eleven RCTs (n = 1129) met inclusion criteria. Continuous feeding significantly improved calorie attainment rate compared with intermittent feeding (MD=3.17,95% CI:1.39-7.22,I2=0%) and led to a greater reduction in APACHE II score (MD=-1.29,95% CI:-2.13--0.46,P=0.002). No statistically significant differences were observed between groups in change in serum albumin (MD=-2.29,95% CI:-9.35-4.76,P=0.52), incidence of aspiration pneumonia(OR=0.84,95% CI:0.22-3.19,P = 0.80), or incidence of diarrhea(OR=0.77,95% CI:0.20-2.97,P = 0.70). Conclusion: Current best evidence indicates that continuous nasogastric feeding—compared with intermittent feeding—enhances energy delivery and is associated with greater improvement in disease severity during EEN in critically ill patients. Both strategies appear equally effective in modulating nutritional biomarkers and preventing key gastrointestinal and pulmonary complications. Keywords: Nasogastric tube feeding; Critically ill patients; Early enteral nutrition; Meta-analysis; Randomized controlled trial

  Key words: Nasogastric tube feeding; Critically ill patients; Early enteral nutrition; Meta-analysis; Randomized controlled trial

  Submit time: 29 April 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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