SynthesisFrontiers in nutrition2026
Enteral nutrition-related hyperglycemia in critical illness: cascade conceptual model and implications for precision nursing-a systematic review.
Synthesis in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
5 authors.
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Abstract
Background: Hyperglycemia is a common complication in critically ill patients receiving enteral nutrition (EN). This review synthesizes evidence on its mechanisms, epidemiology, clinical implications, and nursing management to support precision glycemic care. Methods: A systematic literature search identified 45 eligible studies, including randomized trials, retrospective studies, reviews, guidelines, and expert consensus statements. Given the lack of a universally accepted definition, enteral nutrition-related hyperglycemia was pragmatically defined as blood glucose ≥7.8 mmol/L occurring within 24-72 h after initiation of enteral nutrition. Results: Reported incidence varies widely, from approximately 30-47% in general ICU populations to 60-80% following cardiac surgery, reflecting differences in definitions, patient characteristics, timing, and nutritional protocols. Based on thematic integration of existing evidence, we propose a six-level conceptual cascade framework, linking metabolic vulnerability, stress-hormone activation, exogenous substrate load, enteroinsular axis dysfunction, inflammation-mediated insulin resistance, and microbiota dysbiosis. Corresponding nursing strategies include diabetes-specific formulas, optimized feeding regimens, continuous glucose monitoring, and individualized insulin protocols within multidisciplinary care. These strategies may improve glycemic control; however, evidence for clinical outcome benefits remains limited and heterogeneous. Conclusion: Further prospective studies are needed to validate the model and refine precision nursing strategies.
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