• Nutrition · Jul 2011

    Review Meta Analysis

    Micronutrient supplementation for critically ill adults: a systematic review and meta-analysis.

    • Janicke Visser, Demetre Labadarios, and Renée Blaauw.
    • Division of Human Nutrition, Stellenbosch University and Tygerberg Academic Hospital, South Africa. jconrad@sun.ac.za
    • Nutrition. 2011 Jul 1;27(7-8):745-58.

    ObjectiveThis systematic review assessed the effects of micronutrient supplementation on adults recovering from critical illness. Primary outcomes included clinical endpoints (mortality, infectious complications, length of intensive care unit and of hospital stay). Secondary outcomes included descriptions of practice issues, micronutrient status, morbidity, course of the acute-phase response, and oxidative stress.MethodsElectronic bibliographic databases, bibliographies of retrieved articles, and personal files were searched and reviewed. Randomized controlled trials (RCTs) of micronutrient supplementation in adult critically ill patients administered enterally and/or parenterally in addition to their routine care were included. Two authors independently extracted data and assessed trial quality. The random-effects model was used to estimate overall relative risk (RR)/mean difference and effect size. P<0.05 was considered statistically significant.ResultsFifteen (n=1714) and 18 (n=1849) RCTs were included for the primary and secondary objectives, respectively. Fourteen trials (n=1468) showed a statistically significant decrease in overall mortality (RR 0.78, 95% confidence interval 0.67-0.90, I2=0%, P=0.0009). Six RCTs (n=1194) indicated a statistically significant decrease in 28-d mortality (RR 0.75, 95% confidence interval 0.63-0.88, I2=0%, P=0.0006). Micronutrient supplementation was not associated with a decrease in infectious complications, length of intensive care unit, or length of hospital stay. In subgroup analyses, a sensitivity analysis of combined micronutrients indicated a significant decrease in mortality (RR 0.69, 95% confidence interval 0.54-0.90, I2=2%, P=0.006). The secondary outcomes confirmed that timing, duration, and dosing appear to be key factors to ensure optimal clinical benefit.ConclusionThis review does suggest a potential benefit of micronutrient supplementation in critically ill adults by possibly being associated with a decrease in mortality.Copyright © 2011 Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…