Meta-analysis Of The Effectiveness Of Dietary Fiber Applications In Neurosurgery In Critically Ill Patients

Objective To investigate the influence of enteral nutrition which was rich of dietary fiber on the occurrence of diarrhea, the serum albumin and the GSC. Methods We searched the following electronic databases for randomized controlled trials register about DF:Chinese Biomedicine Database (CBM), PUBMED, EMBASE and Cochrane Controlled Trials Register, CNKI and Wan Fang Digital Journal Full-text database from 2000 to 2010. The search were conducted and extracted by the criteria, by two independent evaluators. Under the quality evaluation criteria of Cochrane Reviewer's Handbook 5.0 RCT and Jadad method, the quality of included studies was assessed. Applied RevMan 5.0 software was used for meta-analysis. We also performed heterogeneity test, sensitivity analysis and publication bias assessment. Results Nine randomized controlled trials with 417 patients were included. In seven trials that compared the supplement of DF in enteral nutrition with standard enteral formula, Combined analysis showed significant reduction in occurrence of diarrhea, the pooled OR was 0.17,95%CI:0.10-0.29, P<0.00001. The result was still stable after sensitivity analysis, funnel polt showed no evidence of publication bias. Eight trials conducted the relationship of supplement of DF in enteral nutrition and serum albumin and there was heterogeneity in the outcome (P=0.0001,I2=76%), random effects model was adopted to analyze. The serum albumin of the DF-supplemented group were higher than the DF-free group distinctly (WMD was 2.59,95%CI:1.13-4.06, P=0.0005). The result was still stable after sensitivity analysis, funnel polt showed evidence of publication bias. Two studies were included with comparing GSC. The result was showed that the GSC was higher in the DF-supplemented group than the DF-free group with WMD was 1.17, 95%CI:0.61-1.72, P<0.0001. Conclusion Supplied the enteral nutrition, which was rich of dietary fiber will improve the nutritional condition of neurosurgical patients, reduce their occurrence of diarrhea and will be favorable to their recuperation.