Jpen Parenter Enter
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Jpen Parenter Enter · Nov 2008
Meta AnalysisThe use of an inflammation-modulating diet in patients with acute lung injury or acute respiratory distress syndrome: a meta-analysis of outcome data.
This meta-analysis of clinical trials compares an inflammation-modulating diet enriched with eicosapentaenoic acid (EPA), gamma-linolenic acid (GLA), and elevated antioxidants (EPA + GLA) vs a control diet to determine the effectiveness of this specialized diet on oxygenation and clinical outcomes in mechanically ventilated patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). ⋯ The meta-analysis showed a significant reduction in the risk of mortality as well as relevant improvements in oxygenation and clinical outcomes of ventilated patients with ALI/ARDS given EPA + GLA.
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Jpen Parenter Enter · Sep 2008
Review Meta AnalysisZinc supplementation in critically ill patients: a key pharmaconutrient?
The purpose of the present paper is to provide a rationale for zinc supplementation as a potential therapeutic agent in critically ill patients by describing its role in health and disease, conducting a systematic review of current randomized trials in critical care, considering optimum route and dose of administration, and making recommendations for future research. Normal zinc homeostasis is required for a functional immune system, adequate antioxidant capacity, glucose homeostasis, and wound healing. In addition, zinc is a required cofactor for many enzymes, transcription factors, and replication factors. ⋯ Thus, because of the paucity of clinical data, there is inadequate evidence to recommend the routine use of high-dose zinc supplementation in the critically ill. A first step would be to determine the optimal dose that has a maximal positive effect on underlying inflammatory, immunologic, and metabolic processes yet is safe and tolerated by critically ill patients. Subsequently, large, rigorously designed, randomized trials are required to elucidate the efficacy of such doses of zinc supplementation in this patient population.
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Jpen Parenter Enter · Nov 2006
Review Meta AnalysisDoes amount of protein in formula matter for low-birthweight infants? A Cochrane systematic review.
High protein intake may be associated with negative consequences such as acidosis, uremia, and elevated levels of circulating amino acids (eg, phenylalanine levels). We performed a systematic review of randomized controlled trials to determine whether formula-fed low-birthweight infants could tolerate protein intakes>or=3.0 g/kg/d in their initial hospital stay, without adverse consequences. ⋯ Accelerated weight and nitrogen accretion were noted with higher protein intakes in "healthy" formula-fed low-birthweight infants. This benefit could not be weighed against the adverse consequences of elevated blood urea nitrogen levels and increased metabolic acidosis and neurodevelopmental abnormalities.
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Jpen Parenter Enter · Mar 2006
Review Meta Analysis Comparative StudyInsulin therapy and in-hospital mortality in critically ill patients: systematic review and meta-analysis of randomized controlled trials.
Hyperglycemia is common in critically ill hospitalized patients and has been associated with adverse outcomes, including increased mortality. In this review, we examine the effect of insulin therapy on mortality in critically ill patients. ⋯ Insulin therapy in adult patients hospitalized for a critical illness, other than hyperglycemic crises, may decrease mortality in certain groups of patients.