Nutrition
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Review Meta Analysis
Effectiveness of immunonutrient-enriched diets in the decrease of infections and mortality in the critically ill.
Pharmaconutrients have been shown in clinical and laboratory studies to modulate human and animal immune responses and thus to have potential benefits for the critically ill. However, reviews and meta-analyses continue to reflect controversy in the published research and a lack of agreement regarding these benefits. The objective of this study was to contribute to the resolution of such controversy by evaluating the effectiveness of immunonutrient-enriched diets in decreasing complications and mortality in patients with different critical illnesses. ⋯ The administration of immunomodulating nutrient-enriched diets did not change the mortality of critically ill or surgical patients, but infection complications in critically ill patients, in particular the surgical population, were decreased. Explanatory clinical trials using isolated immunomodulating nutrients in different populations of critically ill patients followed by pragmatic trials based on clinical trial results should be considered in future research.