Evidence map›Paper›PMID 18626628›Full record

SynthesisIntensive care medicine2008

Immunonutrition in critically ill patients: a systematic review and analysis of the literature.

Paul E Marik, Gary P Zaloga

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Intensive care medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01038622 (Randomized Directed Immuno Nutrition by L-arginine for Critically Ill Patients), which is not on this map. Cited by 69 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
69citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT01038622 phase4completednot on this mapstarted 2009, after this paper: background citation

Randomized Directed Immuno Nutrition by L-arginine for Critically Ill Patients

TypeinterventionalSponsorAssistance Publique - Hôpitaux de ParisRan2009 to 2011Enrolled30ConditionsCritically IllArmsL-arginine, placebo
3 · Its place in the literature

Who cites it

69 citing papers in PubMed, 8 syntheses or guidelines pooled it.

  1. Guideline
  2. Pooled it
  3. Enteral glutamine supplements for patients with severe burns: A systematic review and meta-analysis.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2024
    Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Guideline
  8. Pooled it
  9. Trial
  10. Trial
  11. Trial
  12. Trial
  13. Trial
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  15. Trial
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  17. Review
  18. Article
  19. Review
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9 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors.

Paul E MarikDivision of Pulmonary and Critical Care Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA. paul.marik@jefferson.edu
Gary P Zaloga

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe role of immuno-modulating diets (IMDs) in critically ill patients is controversial.

objectiveThe goal of this meta-analysis was to determine the impact of IMD's on hospital mortality, nosocomial infections and length of stay (LOS) in critically ill patients. Outcome was stratified according to type of IMD and patient setting. DATA SOURCES: MEDLINE, Embase, Cochrane Register of Controlled Trials. STUDY SELECTION: RCT's that compared the outcome of critically ill patients randomized to an IMD or a control diet. DATA SYNTHESIS: Twenty-four studies (with a total of 3013 patients) were included in the meta-analysis; 12 studies included ICU patients, 5 burn patients and 7 trauma patients. Four of the studies used formulas supplemented with arginine, two with arginine and glutamine, nine with arginine and fish oil (FO), two with arginine, glutamine and FO, six with glutamine alone and three studies used a formula supplemented with FO alone. Overall IMD's had no effect on mortality or LOS, but reduced the number of infections (OR 0.63; 95% CI 0.47-0.86, P = 0.004, I(2) = 49%). Mortality, infections and LOS were significantly lower only in the ICU patients receiving the FO IMD (OR 0.42, 95% CI 0.26-0.68; OR 0.45, 95% CI 0.25-0.79 and WMD -6.28 days, 95% CI -9.92 to -2.64, respectively).

conclusionsAn IMD supplemented with FO improved the outcome of medical ICU patients (with SIRS/sepsis/ARDS). IMDs supplemented with arginine with/without additional glutamine or FO do not appear to offer an advantage over standard enteral formulas in ICU, trauma and burn patients.

Indexed as

Enteral NutritionFood, FormulatedArginineCritical CareCritical IllnessCross InfectionFatty Acids, Omega-3GlutamineHospital MortalityHumansIntensive Care UnitsLength of StayRandomized Controlled Trials as TopicArginineFatty Acids, Omega-3Glutamine

Identifiers

PMID18626628

What OpenQuestion holds

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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.