No Benefit From Immune-Enhanced Enteral Nutrition
(HealthDay News) — Use of high-protein enteral nutrition enriched with immune-modulating nutrients (IMHP) does not reduce the incidence of infectious complications among mechanically ventilated, critically ill patients compared to standard high-protein enteral nutrition (HP), according to a study published in the Aug. 6 issue of the Journal of the American Medical Association.
Arthur R.H. van Zanten, MD, PhD, from Gelderse Vallei Hospital in Ede, Netherlands, and colleagues randomized 301 adult intensive care unit (ICU) patients who were expected to be ventilated for >72 hours and to require enteral nutrition for >72 hours to either IMHP or the standard HP enteral nutrition group. The intervention was initiated within 48 hours of ICU admission and continued during the ICU stay for a maximum of 28 days. Intention-to-treat analysis was performed for all patients as a group, as well as predefined medical, surgical, and trauma subgroups.
The researchers observed no statistically significant differences in incidence of new infections between the groups (53% in the IMHP group vs. 52% in the HP group; P=0.96). There were no statistically significant differences in other end points (organ failure, duration of mechanical ventilation, and length of stay), except for a higher six-month mortality rate in the medical subgroup (54% in the IMHP group vs. 35% in the HP group; P=0.04), with a hazard ratio of 1.57 (P=0.04) when adjusted for age and Acute Physiology and Chronic Health Evaluation II score.
"These findings do not support the use of IMHP nutrients in these patients," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.