Document Detail


Early enteral nutrition in critically ill patients with a high-protein diet enriched with arginine, fiber, and antioxidants compared with a standard high-protein diet. The effect on nosocomial infections and outcome.
MedLine Citation:
PMID:  11688933     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This study was designed to evaluate the effects of a high-protein formula enriched with arginine, fiber, and antioxidants compared with a standard high-protein formula in early enteral nutrition in critically ill patients. METHODS: For this study, 220 patients were enrolled in a prospective, multicenter, single-blind, randomized trial in 15 Spanish intensive care units (ICUs). The primary end-points were the incidence density rates of nosocomial infections, ICU and hospital length of stay, ICU and in-hospital mortality, and mortality at 6-month follow-up. RESULTS: The patients in the control and study groups had similar baseline characteristics. The study group had a lower incidence of catheter-related sepsis (0.4 episodes/1000 ICU days) than the control group (5.5 episodes/1000 ICU days), with a relative risk (RR) of 0.07 (95% confidence interval [CI] 0.01 to 0.54, p < .001). There were no differences in the incidence of ventilator-associated pneumonia, surgical infection, bacteremia, or urinary tract infections between the 2 groups. ICU mortality (16% in the study group versus 21% in the control group; RR 1.5, CI 95% 0.7 to 2.9) and in-hospital mortality (21% in the study group versus 30% in the control group; RR 1.6, CI 95% 0.9 to 3) were similar without differences in survival at 6-month follow-up (75% in the study group versus 68% in the control group, p = .15). Patients in the study group who were treated for 2 or more days showed a strong trend for better survival at 6-month follow-up (76% in the study group versus 67% in the control group, p = .06). Medical patients treated with the study diet had better survival than medical patients in the control group (76% in the study group versus 59% in the control group, p < .05). CONCLUSIONS: Critically ill patients fed a high-protein diet enriched with arginine, fiber, and antioxidants had a significantly lower catheter-related sepsis rate than patients fed a standard high-protein diet. There were no differences in mortality or ICU and hospital length of stay. The subgroup of patients fed the study diet for >2 days showed a trend toward decreased mortality.
Authors:
T Caparrós; J Lopez; T Grau
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JPEN. Journal of parenteral and enteral nutrition     Volume:  25     ISSN:  0148-6071     ISO Abbreviation:  JPEN J Parenter Enteral Nutr     Publication Date:    2001 Nov-Dec
Date Detail:
Created Date:  2001-11-01     Completed Date:  2002-05-30     Revised Date:  2007-02-21    
Medline Journal Info:
Nlm Unique ID:  7804134     Medline TA:  JPEN J Parenter Enteral Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  299-308; discussion 308-9     Citation Subset:  IM    
Affiliation:
Fundación Jimenez Díaz, Madrid, Spain. tomascaparros@terra.es
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antioxidants / administration & dosage*
Arginine / administration & dosage
Critical Illness / mortality,  therapy*
Cross Infection / epidemiology*
Dietary Fiber / administration & dosage*
Dietary Proteins / administration & dosage*
Enteral Nutrition / methods*
Female
Follow-Up Studies
Food, Formulated
Hospital Mortality
Humans
Incidence
Intensive Care Units
Length of Stay
Male
Middle Aged
Prospective Studies
Risk Factors
Single-Blind Method
Spain
Survival Analysis
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antioxidants; 0/Dietary Proteins; 74-79-3/Arginine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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