Early nutritional support nursing interventions reduce mechanical ventilation and hospital stay in critical cardiac surgery patients.

This systematic review and meta-analysis examined the impact of early nutritional support nursing interventions on postoperative recovery in patients undergoing critical cardiac surgery. The analysis pooled data from 21 studies encompassing a total sample size of 1846 participants. The specific setting of these studies was not reported in the available data. The primary focus was on evaluating whether early nutritional support nursing interventions could improve various clinical outcomes compared to standard care or other comparators, although the specific comparator arm details were not reported in the input data.

The primary outcome analysis revealed no significant effect on mortality. The pooled odds ratio was 0.694 with a 95% confidence interval ranging from 0.367 to 1.310. Similarly, procedural metrics showed no significant improvement; specifically, there was no significant effect on cardiopulmonary bypass time, with a standardized mean difference of -0.011 (95% CI: -0.287 to 0.264), nor on aortic cross-clamp time, which showed a standardized mean difference of 0.521 (95% CI: -0.140 to 1.183).

However, significant benefits were observed in recovery metrics. The duration of mechanical ventilation was significantly reduced, with a standardized mean difference of -0.306 (95% CI: -0.499 to -0.114, P = .002). Furthermore, the hospital length of stay was significantly reduced, demonstrating a standardized mean difference of -0.462 (95% CI: -0.739 to -0.185, P = .001). In contrast, the length of intensive care unit stay did not show a significant effect, as the specific effect size and confidence intervals were not reported for this outcome.

Safety and tolerability data were not reported in the meta-analysis. Consequently, no specific adverse event rates, serious adverse events, or discontinuation rates could be determined from the provided evidence. The study did not provide details on the specific nursing intervention protocols or the exact dosing schedules for nutritional support, limiting the ability to replicate the intervention precisely.

A key methodological limitation noted was moderate-to-substantial heterogeneity across the included studies for most outcomes. This heterogeneity suggests variability in study designs, patient populations, or intervention implementations that may affect the generalizability of the results. Additionally, the absence of reported funding sources or conflict of interest statements prevents a full assessment of potential biases, although the association noted is observational in nature.

These results indicate that while early nutritional support nursing interventions do not alter mortality or surgical procedural times, they are associated with shorter durations of mechanical ventilation and reduced overall hospital stays. This supports their potential role in enhancing recovery following cardiac surgery. However, the lack of standardized protocols and the presence of heterogeneity highlight the need for further research to identify optimal patient populations and intervention specifics.

Several questions remain unanswered regarding the optimal timing, duration, and specific components of these nursing interventions. Clinicians should interpret these findings cautiously, recognizing that the evidence does not support a claim of mortality benefit. Future studies are needed to standardize protocols and clarify the mechanisms by which these interventions reduce hospital stays without affecting mortality or ICU length of stay.