Effectiveness of immunonutrient-enriched diets in the decrease of infections and mortality in the critically ill

Area of Science:

• Clinical Nutrition
• Critical Care Medicine
• Immunology

Background:

• Pharmaconutrients modulate immune responses, showing potential benefits for critically ill patients.
• Existing research on immunonutrients in critical illness lacks consensus.
• Controversy exists regarding the effectiveness of immunonutrient-enriched diets.

Purpose of the Study:

• To evaluate the effectiveness of immunonutrient-enriched diets in reducing complications and mortality in critically ill patients.
• To resolve controversy surrounding the benefits of immunonutrients in critical care.

Main Methods:

• Meta-analysis of randomized clinical trials.
• Searched PubMed and CINAHL databases for relevant studies.
• Included studies on immunomodulating nutrients in critically ill adults.

Main Results:

• Mortality showed no statistically significant decrease in the general critically ill population (RR 0.92).
• Infection complications were significantly reduced (RR 0.57), particularly in surgical patients (RR 0.56).
• Sepsis incidence was decreased (RR 0.48).

Conclusions:

• Immunomodulating nutrient-enriched diets did not alter mortality in critically ill or surgical patients.
• Significant reduction in infection complications was observed in critically ill patients, especially surgical ones.
• Future research should focus on explanatory trials with isolated immunomodulating nutrients, followed by pragmatic trials.