%0 Journal Article
%A Lopez-Delgado, Juan Carlos
%A Grau-Carmona, Teodoro
%A Trujillano-Cabello, Javier
%A Garcia-Fuentes, Carlos
%A Mor-Marco, Esther
%A Bordeje-Laguna, Maria Luisa
%A Portugal-Rodriguez, Esther
%A Lorencio-Cardenas, Carol
%A Vera-Artazcoz, Paula
%A Macaya-Redin, Laura
%A Martinez-Carmona, Juan Francisco
%A Mateu-Campos, Lidon
%A Gero-Escapa, Maria
%A Gastaldo-Simeon, Rosa
%A Vila-Garcia, Belen
%A Flordelis-Lasierra, Jose Luis
%A Montejo-Gonzalez, Juan Carlos
%A Servia-Goixart, Lluis
%T The Effect of Enteral Immunonutrition in the Intensive Care Unit: Does It Impact on Outcomes?
%D 2022
%U http://hdl.handle.net/10668/21475
%X Background: The present research aimed to evaluate the effect on outcomes of immunonutrition (IMN) enteral formulas during the intensive care unit (ICU) stay. Methods: A multicenter prospective observational study was performed. Patient characteristics, disease severity, nutritional status, type of nutritional therapy and outcomes, and laboratory parameters were collected in a database. Statistical differences were analyzed according to the administration of IMN or other types of enteral formulas. Results: In total, 406 patients were included in the analysis, of whom 15.02% (61) received IMN. Univariate analysis showed that patients treated with IMN formulas received higher mean caloric and protein intake, and better 28-day survival (85.2% vs. 73.3%; p = 0.014. Unadjusted Hazard Ratio (HR): 0.15; 95% CI (Confidence Interval): 0.06−0.36; p< 0.001). Once adjusted for confounding factors, multivariate analysis showed a lower need for vasopressor support (OR: 0.49; 95% CI: 0.26–0.91; p = 0.023) and continuous renal replacement therapies (OR: 0.13; 95% CI: 0.01–0.65; p = 0.049) in those patients who received IMN formulas, independently of the severity of the disease. IMN use was also associated with higher protein intake during the administration of nutritional therapy (OR: 6.23; 95% CI: 2.59–15.54; p < 0.001), regardless of the type of patient. No differences were found in the laboratory parameters, except for a trend toward lower triglyceride levels (HR: 0.97; 95% CI: 0.95–0.99; p = 0.045). Conclusion: The use of IMN formulas may be associated with better outcomes (i.e., lower need for vasopressors and continuous renal replacement), together with a trend toward higher protein enteral delivery during the ICU stay. These findings may ultimately be related to their modulating effect on the inflammatory response in the critically ill.
%K Enteral nutrition
%K Immunonutrition
%K Inflammatory response
%K Intensive care unit
%K Outcomes
%K Protein delivery
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