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The Effect of Enteral Immunonutrition in the Intensive Care Unit: Does It Impact on Outcomes?

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...

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Autores principales: Lopez-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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9103218/
https://www.ncbi.nlm.nih.gov/pubmed/35565870
http://dx.doi.org/10.3390/nu14091904
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author Lopez-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
author_facet Lopez-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
author_sort Lopez-Delgado, Juan Carlos
collection PubMed
description 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.
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spelling pubmed-91032182022-05-14 The Effect of Enteral Immunonutrition in the Intensive Care Unit: Does It Impact on Outcomes? Lopez-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 Nutrients Article 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. MDPI 2022-05-01 /pmc/articles/PMC9103218/ /pubmed/35565870 http://dx.doi.org/10.3390/nu14091904 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lopez-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
The Effect of Enteral Immunonutrition in the Intensive Care Unit: Does It Impact on Outcomes?
title The Effect of Enteral Immunonutrition in the Intensive Care Unit: Does It Impact on Outcomes?
title_full The Effect of Enteral Immunonutrition in the Intensive Care Unit: Does It Impact on Outcomes?
title_fullStr The Effect of Enteral Immunonutrition in the Intensive Care Unit: Does It Impact on Outcomes?
title_full_unstemmed The Effect of Enteral Immunonutrition in the Intensive Care Unit: Does It Impact on Outcomes?
title_short The Effect of Enteral Immunonutrition in the Intensive Care Unit: Does It Impact on Outcomes?
title_sort effect of enteral immunonutrition in the intensive care unit: does it impact on outcomes?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9103218/
https://www.ncbi.nlm.nih.gov/pubmed/35565870
http://dx.doi.org/10.3390/nu14091904
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