Trial reportIntensive care medicine2006
Early enteral immunonutrition vs. parenteral nutrition in critically ill patients without severe sepsis: a randomized clinical trial.
Trial report in Intensive care medicine, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 7 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- Role of probiotic supplementation in preventing ventilator-associated pneumonia among critically ill patients-a critical umbrella review of meta-analyses of randomized controlled trials.Frontiers in nutrition · 2025Pooled it
- Comparison of Early Enteral Nutrition Versus Early Parenteral Nutrition in Critically Ill Patients: A Systematic Review and Meta-Analysis.Nutrients · 2024Pooled it
- Probiotic Supplementation Prevents the Development of Ventilator-Associated Pneumonia for Mechanically Ventilated ICU Patients: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials.Frontiers in nutrition · 2022Pooled it
- Enteral versus parenteral nutrition and enteral versus a combination of enteral and parenteral nutrition for adults in the intensive care unit.The Cochrane database of systematic reviews · 2018Pooled it
- Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012.Intensive care medicine · 2013Guideline
- Prevention, diagnosis, therapy and follow-up care of sepsis: 1st revision of S-2k guidelines of the German Sepsis Society (Deutsche Sepsis-Gesellschaft e.V. (DSG)) and the German Interdisciplinary Association of Intensive Care and Emergency Medicine (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI)).German medical science : GMS e-journal · 2010Guideline
- Guideline
- Enteral citrulline supplementation versus placebo on SOFA score on day 7 in mechanically ventilated critically ill patients: the IMMUNOCITRE randomized clinical trial.Critical care (London, England) · 2023Trial
- The Japanese Critical Care Nutrition Guideline 2024.Journal of intensive care · 2025Review
- Targeted nutritional strategies in postoperative care.Anesthesia and pain medicine · 2025Review
- Gastrin attenuates sepsis-induced myocardial dysfunction by down-regulation of TLR4 expression in macrophages.Acta pharmaceutica Sinica. B · 2023Article
- Does enteral immune nutrition (EIN) boost the immunity of gastric cancer (GC) patients undergoing surgery? A systematic review and meta-analysis.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2023Article
- The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020).Journal of intensive care · 2021Article
- Cost-Effectiveness of Parenteral Nutrition Containing ω-3 Fatty Acids in Hospitalized Adult Patients From 5 European Countries and the US.JPEN. Journal of parenteral and enteral nutrition · 2021Article
- Beneficial Effect of Immune-Enhanced Enteral Nutrition on Immune Function in Patients With Severe Neurological Diseases: A Single-Center Randomized Controlled Trial.Frontiers in nutrition · 2021Article
- Comparison of Complications Following Laparoscopic and Endoscopic Gastrostomy Placements.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2017Article
- Nutrition: A Primary Therapy in Pediatric Acute Respiratory Distress Syndrome.Frontiers in pediatrics · 2016Review
- Continuous renal replacement therapy amino acid, trace metal and folate clearance in critically ill children.Intensive care medicine · 2009Article
- Maximizing efficacy from parenteral nutrition in critical care: appropriate patient populations, supplemental parenteral nutrition, glucose control, parenteral glutamine, and alternative fat sources.Current gastroenterology reports · 2007Review
- Effect of an immune-enhancing diet on lymphocyte in head-injured rats: what is the role of arginine?Intensive care medicine · 2007Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWe compared early parenteral nutrition (PN) and early enteral immunonutrition (iEN) in critically ill patients, distinguishing those with and without severe sepsis or septic shock (SS) on admission to intensive care units (ICUs). DESIGN AND
settingMulticenter, randomized, unblinded clinical trial in 33 Italian general ICUs. PATIENTS AND
participantsThe study included 326 patients, 287 of whom did not have SS on ICU admission. Eligibility criteria excluded the two tails in the spectrum of critical conditions, i.e., patients either too well or too ill. Of the patients recruited 160 were randomized to iEN (142 without SS) and 166 to PN (145 without SS).
interventionsPatients were randomized to two arms: early iEN or early PN. MEASUREMENTS AND
resultsPrimary endpoint was 28-day mortality for all patients and the occurrence of SS during ICU stay for patients admitted without such condition. While 28-day mortality did not differ between iEN and PN (15.6% vs. 15.1%), patients without SS who received iEN had fewer episodes of severe sepsis or septic shock (4.9% vs. 13.1%). ICU length of stay was 4 days shorter in patients given iEN.
conclusionsCompared to parenteral nutrition iEN appears to be beneficial in critical patients without severe sepsis or septic shock. Parenteral nutrition in these patients should be abandoned, at least when enteral nutrition can be administered, even at an initial low caloric content.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.