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Title: | The Effect of Enteral Immunonutrition in the Intensive Care Unit: Does It Impact on Outcomes? |
Author: | López Delgado, Juan Carlos Grau Carmona, Teodoro Trujillano Cabello, Javier García Fuentes, Carlos Mor Marco, Esther Bordeje Laguna, Maria Luisa Portugal Rodriguez, Esther Lorencio-cardenas, Carol Vera Artazcoz, Paula Macaya Redin, Laura Martinez Carmona, Juan Francisco Mateu Campos, Lidón Gero Escapa, Maria Gastaldo Simeon, Rosa Vila García, Belen Flordelis Lasierra, José Luis Montejo Gonzalez, Juan Carlos Servia Goixart, Lluís ENPIC Study Investigators |
Keywords: | Medicina d'urgència Alimentació enteral Emergency medicine Enteral feeding |
Issue Date: | 1-May-2022 |
Publisher: | MDPI |
Abstract: | Background: The present research aimed to evaluate the effect on outcomes of immunonutrition (IMN) enteral formulas during the intensive care unit (ICU) stay. Methods: A multicenter prospective observational study was performed. Patient characteristics, disease severity, nutritional status, type of nutritional therapy and outcomes, and laboratory parameters were collected in a database. Statistical differences were analyzed according to the administration of IMN or other types of enteral formulas. Results: In total, 406 patients were included in the analysis, of whom 15.02% (61) received IMN. Univariate analysis showed that patients treated with IMN formulas received higher mean caloric and protein intake, and better 28-day survival (85.2% vs. 73.3%; p = 0.014. Unadjusted Hazard Ratio (HR): 0.15; 95% CI (Confidence Interval): 0.06-0.36; p < 0.001). Once adjusted for confounding factors, multivariate analysis showed a lower need for vasopressor support (OR: 0.49; 95% CI: 0.26-0.91; p = 0.023) and continuous renal replacement therapies (OR: 0.13; 95% CI: 0.01-0.65; p = 0.049) in those patients who received IMN formulas, independently of the severity of the disease. IMN use was also associated with higher protein intake during the administration of nutritional therapy (OR: 6.23; 95% CI: 2.59-15.54; p < 0.001), regardless of the type of patient. No differences were found in the laboratory parameters, except for a trend toward lower triglyceride levels (HR: 0.97; 95% CI: 0.95-0.99; p = 0.045). Conclusion: The use of IMN formulas may be associated with better outcomes (i.e., lower need for vasopressors and continuous renal replacement), together with a trend toward higher protein enteral delivery during the ICU stay. These findings may ultimately be related to their modulating effect on the inflammatory response in the critically ill. NCT Registry: 03634943. |
Note: | Reproducció del document publicat a: https://doi.org/10.3390/nu14091904 |
It is part of: | Nutrients, 2022, vol. 14, num. 9 |
URI: | http://hdl.handle.net/2445/186097 |
Related resource: | https://doi.org/10.3390/nu14091904 |
ISSN: | 2072-6643 |
Appears in Collections: | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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nutrients-14-01904-v2.pdf | 1.42 MB | Adobe PDF | View/Open |
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