| 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. | |
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MedLine Citation:
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PMID: 11688933 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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T Caparrós; J Lopez; T Grau |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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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:
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Created Date: 2001-11-01 Completed Date: 2002-05-30 Revised Date: 2007-02-21 |
Medline Journal Info:
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Nlm Unique ID: 7804134 Medline TA: JPEN J Parenter Enteral Nutr Country: United States |
Other Details:
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Languages: eng Pagination: 299-308; discussion 308-9 Citation Subset: IM |
Affiliation:
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Fundación Jimenez Díaz, Madrid, Spain. tomascaparros@terra.es |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Antioxidants; 0/Dietary Proteins; 74-79-3/Arginine |
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