To examine the influence of early enteral nutrition (EEN) on the time course of metabolic and inflammatory biomarkers in patients with sepsis, highlighting its significance in clinical outcomes.
Key Findings:
Distinct trajectory groups for albumin, lactate, and procalcitonin were identified, indicating heterogeneous responses.
EEN was associated with favorable albumin trajectories and lower odds of elevated lactate and procalcitonin patterns, with statistical significance noted.
Three trajectory classes emerged: stable-low inflammation (67.5%), intermediate-transient (21.7%), and high-risk inflammatory surge (10.8%).
EEN reduced the likelihood of being in the intermediate (OR 0.66) and high-risk (OR 0.57) classes, with confidence intervals provided.
The high-risk trajectory group had significantly increased 28-day mortality.
Interpretation:
EEN initiation is linked to improved biomarker trajectories, potentially explaining reduced short-term mortality in septic patients, with implications for clinical practice.
Limitations:
Retrospective design may introduce biases, including selection and recall bias.
Findings may not be generalizable beyond the studied population, particularly in different healthcare settings.
Conclusion:
EEN is associated with a higher probability of remaining in low-risk biomarker trajectories and a lower probability of entering high-risk patterns, which may contribute to reduced mortality, emphasizing its importance in sepsis management.
