Randomized trial of immune-enhancing enteral nutrition in burn patients

"Immune-enhancing" diets (IEDs) are aimed at improving outcomes in patients suffering trauma and infection. This study was conducted to evaluate a popular IED in patients suffering burn injury.

Fifty burned patients were randomized to receive either Impact (Sandoz Nutrition, Minneapolis, Minn), an IED enhanced with omega-3 fatty acids, arginine, and RNA, or Replete (Clintec, Deerfield, Ill), our standard high-protein diet. Feedings were begun within 48 hours of injury, and continued until patients supported themselves with oral intake.

Forty-nine patients completed the study. The two feeding groups did not differ with respect to age, burn size, incidence of inhalation injury, or the quantity of calories and protein received. There were no differences between groups in mortality, length of hospitalization, hospital charges, days of ventilator support, or incidence of complications. Patients with inhalation injuries required more ventilatory support, and had longer lengths of hospitalization and higher costs.

Administration of an IED has no clear advantages over the use of less expensive high-protein enteral nutrition in burn patients.