Should Immunonutrition Become Routine in Critically Ill Patients? A Systematic Review of the Evidence

Article Abstract:

Certain nutrients when added to enteral feeding may reduce the risk of infection in critically ill patients, according to researchers who analyzed 22 clinical trials covering 2,419 patients. However, the nutrients, which included arginine, glutamine, nucleotides, and omega-3 fatty acids, did not affect mortality rates.

Infection, Composition, Enteral feeding, Enteral nutrition

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Stress ulcer prophylaxis in critically ill patients: resolving discordant meta-analyses

Article Abstract:

Histamine2-receptor blockers appear to be effective in preventing gastrointestinal bleeding in people with stress ulcers. Several meta-analyses of the effectiveness of anti-ulcer drugs have produced mixed results. Researchers reviewed 63 randomized clinical trials of anti-ulcer drugs in the prevention of overt and silent gastrointestinal bleeding. Histamine2-receptor blockers significantly reduced both overt and silent bleeding when compared to antacids, a placebo or no therapy. Sucralfate and antacids reduced overt bleeding compared to placebo or no therapy, but neither appeared more effective than histamine2-receptor blockers. However, sucralfate lowered the incidence of pneumonia when compared to antacids and histamine2-receptor blockers. In fact, histamine2-receptor blockers were associated with an increased incidence of pneumonia. Sucralfate appeared to reduce mortality rates when compared to antacids and histamine2-receptor blockers.

Gastrointestinal bleeding, Gastrointestinal hemorrhage, Antiulcer agents, Peptic ulcer, Antacids, Antiulcer drugs, Sucralfate

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Total Parenteral Nutrition in the Critically III Patient: A Meta-Analysis

Article Abstract:

Many critically ill patients may not require total parenteral nutrition (TPN). TPN is a type of tube feeding that bypasses the gastrointestinal tract. Researchers analyzed 26 clinical trials of TPN in 2,211 critically ill hospital patients published between 1980 and 1998. All the studies compared TPN to a standard oral diet. TPN did not reduce mortality rates but it did lead to a lower rate of complications in malnourished patients. Studies published before 1988 showed an advantage in using TPN but high-quality studies published since 1989 showed no such advantage.

United States, Parenteral feeding, Parenteral nutrition

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