Early enteral nutrition supplemented with probiotics improved the clinical outcomes in severe head injury: Some promising findings from Chinese patients

BACKGROUND: The role of early enteral nutrition (ENN) supplemented with probiotics (<48 hours) in improving clinical outcomes of patients with severe head injury (SHI) remains controversial. We performed this meta-analysis to investigate the efficacy of EEN supplemented with probiotics on clinical outcomes in these patients. METHODS: Systematic searches were performed in PubMed, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang database, and Chinese Biomedical Literature to identify potential studies. Two investigators checked citations, extracted data, appraised risk of bias, and then STATA 12.0 was used to perform statistical analysis. RESULTS: A total of 18 trials were eventually included in the present study. Meta-analysis indicated that EEN supplemented with probiotics was associated with decreased risk of infection (risk ratio [RR], 0.53; 95% confidence interval [CI], 0.44–0.65), decreased risk of mortality (RR, 0.56; 95% CI, 0.38–0.82), decreased risk of gastrointestinal complications (RR, 0.19; 95% CI, 0.13–0.25), and shortened stays in intensive care unit (ICU) (mean difference [MD], −4.55; 96% CI, −5.91 to −3.19). CONCLUSION: EEN supplemented with probiotics may be a promising alternative for patients with SHI because it effectively decreased the risk of infection, mortality, and gastrointestinal complications, as well as shortened the stays in ICU.