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EBP Compendium: Summary of Systematic Review

Does Enteral Nutrition Affect Clinical Outcome? A Systematic Review of the Randomized Trials

Koretz, R. L., Avenell, A., et al. (2007).
The American Journal of Gastroenterology, 102(2), 412-429; quiz 468.

Indicators of Review Quality:

The review addresses a clearly focused question Yes
Criteria for inclusion of studies are provided Yes
Search strategy is described in sufficient detail for replication Yes
Included studies are assessed for study quality Yes
Quality assessments are reproducible Yes


This is a systematic review of randomized controlled trials (RCTs) addressing the use of enteral nutrition, parenteral nutrition, or volitional nutrition support for individuals with various stages and types of disease processes. Evidence is divided into five grades:

A- One or more high-quality RCTs demonstrated benefit.
B- Evidence of benefit was limited to low-quality RCTS.
C- Inadequate data to decide if a benefit is present or absent.
D- Limited evidence was not able to define a benefit.
E- One or more high-quality RCTs indicated that the intervention was not effective or if there was any evidence it caused harm.

Question(s) Addressed:

Does enteral nutrition affect clinical outcome?

Population: Participants provided EN or VNS as part of a treatment plan for an underlying disease process.

Intervention/Assessment: Enteral nutrition (EN), parenteral nutrition (PN), and volitional nutrition support (VNS)

Number of Studies Included: 135

Years Included: From 1975 (published in 2007)



  • Treatment
    • Swallowing/Feeding
      • Tube Feeding
        • PN trophic feedings reduced time to full feeding by 2.7 days and duration of hospitalization by 15.6 days (Grade B).
        • There was insufficient evidence (Grade C) to determine if enteral nutrition was of benefit to other pediatric conditions besides low birth weight infants.

Keywords: Tube Feeding

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Added to Compendium: December 2011

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