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Intensive Care Medicine
Published in: Intensive Care Medicine 4/2006

01-04-2006 | Year in Review 2005

Year in review in intensive care medicine, 2005. III. Nutrition, pediatric and neonatal critical care, and experimental

Authors: Peter Andrews, Elie Azoulay, Massimo Antonelli, Laurent Brochard, Christian Brun-Buisson, Geoffrey Dobb, Jean-Yves Fagon, Herwig Gerlach, Johan Groeneveld, Jordi Mancebo, Philipp Metnitz, Stefano Nava, Jerome Pugin, Michael Pinsky, Peter Radermacher, Christian Richard, Robert Tasker

Published in: Intensive Care Medicine | Issue 4/2006

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Excerpt

The potential benefit of enteral immunonutrition remains uncertain and controversial despite numerous previous studies. Kieft and colleagues [1] completed another clinical trial in two ICUs. Strengths of their study are the randomized, double-blind design, inclusion of 597 adult ICU patients, and intention-to-treat analysis. The control feeds were isocaloric but the “immunonutrition” (Stresson Multi Fibre, Nutricia) had a higher total protein content. Immunonutrition had no effect on patient outcome regardless of whether assessed on a intention-to-treat or per-protocol basis. The authors also carried out post-hoc subgroup analyses in groups of interest: those with sepsis and Acute Physiology and Chronic Health Evaluation (APACHE) II scores of 10–20. Patients with sepsis are thought to be harmed by arginine-supplemented feeds, but no statistically significant difference was found in the small group (n = 30) of patients with sepsis. It is suggested midrange APACHE II score patients (n = 336) may benefit from immunonutrition, but no statistically significant difference was found in this study. However, a further post-hoc analysis in women (n = 170) showed a consistent trend to worse outcomes if given immunonutrition. As pointed out by the authors, this gender difference warrants further investigation. …
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Metadata
Title
Year in review in intensive care medicine, 2005. III. Nutrition, pediatric and neonatal critical care, and experimental
Authors
Peter Andrews
Elie Azoulay
Massimo Antonelli
Laurent Brochard
Christian Brun-Buisson
Geoffrey Dobb
Jean-Yves Fagon
Herwig Gerlach
Johan Groeneveld
Jordi Mancebo
Philipp Metnitz
Stefano Nava
Jerome Pugin
Michael Pinsky
Peter Radermacher
Christian Richard
Robert Tasker
Publication date
01-04-2006
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 4/2006
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-006-0068-y

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