Impact of Personalized Parenteral Nutrition on Inflammatory Markers and Clinical Outcomes in Critically Ill Patients: A Systematic Review and Meta-analysis

个体化肠外营养对危重患者炎症标志物和临床结局的影响:系统评价和荟萃分析

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Abstract

BACKGROUND AND AIMS: Personalized parenteral nutrition (PPN) is a customized strategy to address the individual metabolic and nutritional requirements of the critically ill patients, especially in cases where enteral nutrition (EN) is not possible. However, available evidence regarding its effectiveness and safety is still inconclusive. This systematic review and meta-analysis aim to evaluate the impact of PPN on the clinical outcome of critically ill patients, including its effect on their length of stay in the intensive care unit (ICU), morbidity, and mortality. METHODOLOGY: A systematic literature search was conducted in PubMed, EMBASE, and Cochrane databases. Information pertinent to the question was retrieved from the selected studies by using a structured data extraction form. Included studies were those that had assessed the impact on clinical outcomes of PPN in critically ill patients. Data were synthesized using a random-effects meta-analysis model. An odds ratio (OR) with 95% confidence intervals (CIs) was used as the pooled effect size. RESULTS: The meta-analysis included seven studies. The clinical risk was significantly higher in PPN with an OR of 1.24 (95% CI: 1.10-1.39; p < 0.01). Although there were some studies that showed an improvement in nutritional markers and decreased inflammation, the overall impact on mortality and the length of stay in the ICU was inconsistent with considerable clinical and methodological heterogeneity (I² = 81%). CONCLUSION: Personalized parenteral nutrition has demonstrated improved benefits in tailored nutritional support for critically ill patients. The evidence, however, has shown mixed clinical outcomes, and its effect on mortality and morbidity has been inconclusive. Future research is needed to optimize the composition of PPN formulations and evaluate the long-term effects of this intervention. HOW TO CITE THIS ARTICLE: Gatar O, Arishi AA, Sultan MA, Gatar MM. Impact of Personalized Parenteral Nutrition on Inflammatory Markers and Clinical Outcomes in Critically Ill Patients: A Systematic Review and Meta-analysis. Indian J Crit Care Med 2025;29(12):1040-1049.

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