Immunonutrition as an adjuvant therapy for burns.

Area of Science:

• Clinical Nutrition
• Burn Management
• Immunonutrition

Background:

• Severe burn injuries disrupt the body's nutritional status and skin barrier, increasing infection and fluid loss risks.
• Nutritional support, specifically immunonutrition, targets immune system modulation via nutrients like glutamine, arginine, and omega-3 fatty acids.
• Key immunonutrition targets include mucosal barrier function, cellular defense, and inflammation control.

Purpose of the Study:

• To evaluate the impact of immunonutrient-enriched diets on clinical outcomes in severe burn patients.
• To compare immunonutrition interventions against isonitrogenous diets in burn injury management.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials.
• Searched multiple databases (Cochrane, MEDLINE, Embase) and handsearched journals up to October 2014.
• Assessed mortality, hospital length of stay, and infection rates (burn wound and non-wound).

Main Results:

• Sixteen trials with 678 participants were included; most studies had methodological limitations.
• Glutamine supplementation showed a potential reduction in hospital stay (mean -5.65 days) and mortality (RR 0.25).
• These glutamine findings require cautious interpretation due to small sample sizes; other immunonutrients showed no significant effects.

Conclusions:

• Preliminary evidence suggests glutamine may reduce mortality in severe burn patients, but findings are not definitive.
• The current evidence base is insufficient to recommend or refute glutamine use.
• Larger, robust studies are necessary to establish the efficacy of glutamine and other immunonutrients in burn care.