ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1620011
This article is part of the Research TopicEmerging Perspectives on Precision Nutrition in Critical Illness: Targeting Gut Microbiota and Immune Function for Improved OutcomesView all articles
Impact of Early Enteral Nutrition on the Prognosis of Mechanically Ventilated Patients with Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study Based on the MIMIC-IV Database
Provisionally accepted
- Guangdong Second Provincial General Hospital, Guangzhou, China
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AbstractBackground: While early enteral nutrition (EN) is recommended for critically ill patients, its specific impact on mechanically ventilated chronic obstructive pulmonary disease (COPD) patients remains uncertain. Methods: We analyzed data extracted from the MIMIC-IV 3.0 database, focusing on patients with COPD who received invasive mechanical ventilation. The cohort was stratified into two groups: the early EN group (EEN, EN initiated within 48 hours of ICU admission), and the delayed EN group (DEN, EN initiated after 48 hours of ICU admission). Propensity score matching (PSM) was employed to balance baseline characteristics between the groups, enabling a comparative analysis of clinical outcomes.Results: Among 1,052 patients, 513 (48.76%) were in the early EN group and 539 (51.24%) were in the delayed EN group. After PSM, no statistically significant differences were observed in 28-day mortality (30.51% vs. 32.82%, p=0.488), ICU mortality (17.18% vs. 21.28%, p=0.146), or 60-day mortality (38.21% vs. 39.74%, p=0.660). Similarly, the incidence of ventilator-associated pneumonia (VAP) did not differ significantly between the EEN and DEN groups (20.77% vs. 23.33%, p=0.388). However, the EEN group exhibited a significantly shorter duration of mechanical ventilation (127.50 vs. 137.94 hours, p=0.023), reduced ICU length of stay (9.08 vs. 10.07 days, p<0.01) and total hospitalization (14.64 vs 16.63 days, p=0.001). Additionally, subgroup analysis revealed that EEN significantly reduced 28-day mortality in patients with PaO2/FiO2 >200 (OR = 0.626, 95% CI: 0.414–0.943; p = 0.026).Conclusion: Although early EN did not significantly improve overall mortality, it effectively decreased ventilation duration and hospital stays and demonstrated potential survival benefits for patients with better oxygenation. These findings provide critical evidence for optimizing nutritional support strategies in mechanically ventilated COPD patients.
Keywords: Early enteral nutrition, chronic obstructive pulmonary disease, prognosis, Propensity score matching, MIMIC-IV
Received: 29 Apr 2025; Accepted: 25 Jul 2025.
Copyright: © 2025 OUYANG, WANG and SONG. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yunfeng SONG, Guangdong Second Provincial General Hospital, Guangzhou, China
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