¬The Effect of Immunomodulatory Diet (Omega-3 Fatty Acid, γ-Linolenic
Acid and Antioxidants) on clinical outcomes in critically ill patients
Abstract
Enteral immunomodulatory nutrition is suggested as an adjuvant therapy
for patients admitted in intensive care units (ICU), but its
effectiveness remains debated. The aim of this systematic review and
meta-analysis is to examine the effect of dietary immunomodulatory
formula on the clinical outcomes and risk of overall mortality in
critically ill patients. PubMed, Scopus and ISI web of Knowledge
databases were searched until September 2019. Randomized Controlled
Trials (RCTs) that used immunomodulatory diet containing omega-3 fatty
acid, γ-linolenic acid and antioxidants in ICU were included. Ten RCTs
including 1166 participants were included in the meta-analysis.
Immunomodulatory diet containing omega-3 fatty acid, γ-linolenic acid
and antioxidants led to significantly reduce the duration of ICU stays
(WMD: −2.97 days; 95%CI: -5.59, -0.35), duration of mechanical
ventilation (WMD = -2.20 days, 95%CI: -4.29, -0.10), SOFA (sequential
organ failure assessment) and MOD (multiple organ dysfunction) score
(Hedge’s g: -0.42 U/L; 95% CI: -0.74, -0.11). The 28 days’ overall
mortality was remarkably decreased following Immunomodulatory supplement
in critically ill patients (RR = 0.74, 95% CI: 0.58, 0.91) and extended
the ICU- free days (WMD: 4.06 days, 95%CI: 0.02, 8.09). However,
immunomodulatory formula had no significant effect on length of hospital
stays, ventilator- free days and level of oxygenation.Immunomodulatory
diet containing omega-3 fatty acid, γ-linolenic acid and antioxidants
might have beneficial effects for the patient’s residing in ICU;
However, further well-designed RCTs with larger sample size are
recommended to confirmed its effect.