Clinical nutrition : official journal of the European Society of Parenteral and Enteral Nutrition
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Meta Analysis
Cost-effectiveness analysis of immune-modulating nutritional support for gastrointestinal cancer patients.
Immune-modulating nutritional formula containing arginine, omega-3 fatty acids and nucleotides has been demonstrated to decrease complications and length of stay in surgical patients. This study aims at assessing the impact of immune-modulating formula on hospital costs in gastrointestinal cancer surgical patients in Switzerland. ⋯ Immune-modulating nutritional solution is a cost-saving intervention in gastrointestinal cancer patients. The additional cost of immune-modulating formula are more than offset by savings associated with decreased treatment of complications.
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Review Meta Analysis
Does intravenous fish oil benefit patients post-surgery? A meta-analysis of randomised controlled trials.
Supplementation of fish oil (FO) containing lipid emulsions has been associated with a reduction in the length of hospital stay, infections and liver dysfunction in patients undergoing major surgery. We carried out a meta-analysis and subgroup analysis to examine randomised clinical trial (RCT)-based evidence of the aforementioned effects. ⋯ FO-enriched lipid emulsions are likely to reduce infections, the length of hospital stay and liver dysfunction without influencing mortality and may be a safe and preferable choice in post-surgery patients. Further well-designed trials should be performed to determine whether FO lipid emulsions reduce mortality in patients undergoing hepatic surgery, especially liver transplantation, and the cost effectiveness of such treatment.
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Review Meta Analysis
The presence and effect of bias in trials of early enteral nutrition in critical care.
Randomized trials suggest that early enteral nutrition is beneficial in critically ill adults. However, methodologic bias can overestimate benefit. ⋯ The benefits attributed to early enteral nutrition were either seen only in trials with high risks of bias or may result from residual risks of bias.
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The efficacy of homocysteine-lowering therapy with folic acid to lower homocysteine levels in an effort to reduce cardiovascular disease (CVD) risk in patients with kidney disease remains inconclusive. We conducted a meta-analysis of relevant randomized trials to further examine this issue. ⋯ Our meta-analysis indicates that folic acid supplementation may be effective for CVD prevention in patients with kidney disease, particularly in trials among patients without a history of grain fortification with folic acid, with lower percent baseline diabetes, and in patients with ESRD or ACKD.
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Review Meta Analysis
A systematic literature review and meta-analysis of randomized clinical trials of parenteral glutamine supplementation.
Glutamine supplementation has been associated with reduced mortality, infections and hospital length of stay in critically ill patients and patients undergoing major surgery. We carried out a meta-analysis to examine randomized clinical trial (RCT)-based evidence of these effects. ⋯ Parenteral glutamine supplementation in severely ill patients may reduce infections, length of stay and mortality, but substantial uncertainty remains. Unlike previous meta-analyses, we could not demonstrate a significant reduction in mortality.