[An appraisal of immunonutrition for clinical nutritional support with a systematic review of English and Chinese documents].
OBJECTIVE
To evaluate the efficacy, safty and economical values of immunonutrition for clinical nutritional support.


METHODS
The following electronic databases were searched: Chinese Biomedicine database (CBM), MEDLINE, EMBASE, Cochrane Library and SCI. Data were extracted by two reviewers. RevMan 4.1 was applied for statistical analysis.


RESULTS
Seventeen randomised trials comparing the use of immunonutrition which comprises nucleotides, omega-3 fatty acids and arginine with standard enteral nutrition in surgical, trauma/burn and critical illness patients. Combined analysis indicated that the use of immunonutrition decreased infectious events (pooled OR was 0.51, 95%CI [0.38, 0.67], P = 0.00001), length of hospitalization, and the cost. In sensitivity analysis for mortality, we found an increased tendency in immunonutrition (pooled OR was 1.94, 95%CI [1.05, 3.57], P = 0.03). Further sub-group analysis indicated that the effects of immunonutrition were various in different patient types.


CONCLUSIONS
Immunonutrition is associated with decreasing of infectious rates, length of hospitalization and cost in selective operation patients. But current evidence can't affirm the role of immunonutrition on critical illness patients. Further studies are urgently needed to clarify the reliability of immunonutrition in this group.
Jiang
Hua
H
Department of Surgery, West China Hospital, Sichuan University, Chengdu 610041, China. trauma_120@163.com
Jiang
Zhu-ming
ZM
Luo
Bin
B
Shuai
Xiao
X
Li
You-ping
YP
D001120:Arginine / Q000008:administration & dosage; D016638:Critical Illness; D004750:Enteral Nutrition / Q000379:methods; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage; D005526:Food, Formulated; D005973:Glutamine / Q000008:administration & dosage; D006801:Humans; D007107:Immune System / Q000187:drug effects; D009711:Nucleotides / Q000008:administration & dosage; D018529:Nutritional Support; D017063:Outcome Assessment, Health Care
D015525:Fatty Acids, Omega-3; D009711:Nucleotides; D005973:Glutamine; D001120:Arginine