Standard vs Enriched High Protein Enteral Nutrition in the ICU

Buijs, Nikki; Leeuwen, Paul A. M. van

doi:10.1001/jama.2014.14493

JAMA

2014

DOI: 10.1001/jama.2014.14493

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Standard vs Enriched High Protein Enteral Nutrition in the ICU

Nikki Buijs

Paul A. M. van Leeuwen

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2015

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Cited by 2 publications

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“…Secondary analysis has no statistical power and therefore is of no value but is only hypothesis generating. Moreover, the study was underpowered 3 to show a difference in mortality. van Zanten et al compare their 6‐month mortality graph with the graph by Heyland et al 4 It is clearly written in the protocol in 2005 that 6‐month mortality was neither a primary nor secondary end point.…”

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confidence: 99%

Consequences of the REDOXS and METAPLUS Trials

Vermeulen¹,

Brinkmann²,

Stehle³

et al. 2015

J Parenter Enteral Nutr

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mentioning

confidence: 99%

Consequences of the REDOXS and METAPLUS Trials

Vermeulen¹,

Brinkmann²,

Stehle³

et al. 2015

J Parenter Enteral Nutr

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Enteral glutamine supplementation in critically ill patients: a systematic review and meta-analysis

et al. 2015

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IntroductionGlutamine (GLN) has been suggested to have a beneficial influence on outcomes of critically ill patients. However, recent large-scale trials have suggested harm associated with GLN supplementation. Recently, systematic reviews on the use of parenteral GLN have been published; however, less information is available on the role of enteral GLN. Therefore, the aim of this systematic review was to study the effects of enteral GLN supplementation in patients with critical illness.MethodsWe identified randomized controlled trials conducted from 1980 to 2014 with enterally administered GLN in adult critically ill patients. Studies of parenteral GLN only or combined enteral-parenteral GLN were excluded. The methodological quality of studies was scored, and trial data were statistically combined. We examined a priori the treatment effects in subgroups of trials of burn and trauma patients.ResultsA total of 11 studies involving 1079 adult critically ill patients and enteral GLN supplementation were identified. Enteral GLN supplementation was not associated with a reduction of hospital mortality (risk ratio [RR] 0.94, 95 % confidence interval [CI] 0.65–1.36; p =0.74), infectious complications (RR 0.93, 95 % CI 0.79–1.10; p =0.39) or stay in the intensive care unit (weighted mean difference [WMD] −1.36 days, 95 % CI −5.51 to 2.78; p =0.52). However, there was a significant reduction in hospital stay (WMD 4.73 days, 95 % CI −8.53 to −0.90; p =0.02). In the subset of studies of patients with burns, enteral GLN supplementation was associated with significant reductions in hospital mortality (RR 0.19, 95 % 0.06–0.67; p =0.010) and hospital stay (WMD −9.16, 95 % CI −15.06 to −3.26; p =0.002). There was no effect in trauma patients.ConclusionsEnteral GLN supplementation does not confer significant clinical benefit in critically ill patients, with the exception of reduced hospital stay. There may be a significant benefit in patients with burns, but data are sparse and larger randomized trials are warranted to confirm this effect.

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Standard vs Enriched High Protein Enteral Nutrition in the ICU

Cited by 2 publications

References 1 publication

Consequences of the REDOXS and METAPLUS Trials

Consequences of the REDOXS and METAPLUS Trials

Enteral glutamine supplementation in critically ill patients: a systematic review and meta-analysis

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