Abstract
Introduction: In nutritional therapies, appropriate or precise nutritional interventions are used in critically ill patients. Nutrition is considered a palliative treatment. Dietary counseling, provision of nutritional support, and alleviation of diet-related issues should be an essential component of a holistic approach to palliative and end-of-life care. Objective: This study aimed to highlight the main clinical outcomes and guidelines on nutritional therapies and palliative care in critically ill cancer patients. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from June to August 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 133 articles were found. A total of 44 articles were evaluated in full and 22 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 22 studies with a high risk of bias and 27 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=75.7%>50%. It was concluded that according to the ESPEN and ASPEN guidelines, no differences in clinical outcomes were identified between numerous nutritional interventions, including increased energy or protein intake, parenteral nutrition or isocaloric enteral nutrition, supplemental parenteral nutrition or different mixed oil lipid injectable emulsions. However, clinical judgment and close monitoring along with appropriate palliative care are required. Decisionmaking in this field must be carried out on an individual basis, weighing the benefits and harms that may cause to patients' quality of life. The guidelines recommend that, if oral food intake remains inadequate despite counseling and oral nutritional supplements, enteral nutrition or, if this is not sufficient or feasible, parenteral nutrition (supplemental or total) should be considered.