title: [An appraisal of immunonutrition for clinical nutritional support with a systematic review of English and Chinese documents].
abstract: 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.
authors.affiliation: Department of Surgery, West China Hospital, Sichuan University, Chengdu 610041, China. trauma_120@163.com
authors.forename: Hua
authors.initials: H
authors.lastname: Jiang
authors.forename: Zhu-ming
authors.initials: ZM
authors.lastname: Jiang
authors.forename: Bin
authors.initials: B
authors.lastname: Luo
authors.forename: Xiao
authors.initials: X
authors.lastname: Shuai
authors.forename: You-ping
authors.initials: YP
authors.lastname: Li
mesh_terms: 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
chemical_list: D015525:Fatty Acids, Omega-3; D009711:Nucleotides; D005973:Glutamine; D001120:Arginine