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The effect of immunonutrition in patients with acute pancreatitis: a systematic review and meta-analysis.
J Hum Nutr Diet. 2021 04; 34(2):429-439.JH

Abstract

BACKGROUND

The effect of immunonutrition is controversial compared to standard supplementation with respect to the management of patients with acute pancreatitis.

METHODS

An online literature search on four databases (PubMed, Cochrane, Embase and Web of Science) was performed to identify all of the randomised controlled trials assessing the effects of enteral or parenteral immunonutrition in acute pancreatitis. A fixed or random effects model was chosen using revman, version 5.3 (https://revman.cochrane.org). The count data were analysed using the risk ratio (RR) and 95% confidence interval (CI).

RESULTS

Five hundred and sixty-eight patients were included via our search in which 14 articles matched our criteria for enrolling the meta-analysis. Immunonutrition significantly reduced the risk of organ failure (RR = 0.42; 95% CI = 0.26-0.70, P = 0.0008), infectious complications (RR = 0.78; 95% CI = 0.62-0.99; P = 0.04) and mortality (RR = 0.37; 95% CI = 0.21-0.66; P = 0.006). Length of hospital stay was also shorter in patients who received immunonutrition (mean difference = -1.73 days; 95% CI = -2.36 to -1.10; P < 0.00001). Total interventions of patients were decreased (RR = 0.73; 95% CI = 0.55-0.97; P = 0.03). Body mass index in patients with immunonutrition was reduced more than standard nutrition (mean difference = -2.00; 95% CI = -3.96 to -0.04; P = 0.05).

CONCLUSIONS

Immunonutrition support such as glutamine and ω-3 fatty acids is potentially beneficial with respect to improving clinical outcomes in patients with acute pancreatitis.

Authors+Show Affiliations

Surgical Intensive Care Unit (SICU), Department of General Surgery, Jinling Hospital, Medical School of Southeast University, Nanjing, China. Department of Clinical Medicine, School of Medicine, Southeast University, Nanjing, China.Department of Clinical Medicine, School of Medicine, Southeast University, Nanjing, China.Surgical Intensive Care Unit (SICU), Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.Department of Clinical Medicine, School of Medicine, Southeast University, Nanjing, China.Surgical Intensive Care Unit (SICU), Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.Surgical Intensive Care Unit (SICU), Department of General Surgery, Jinling Hospital, Medical School of Southeast University, Nanjing, China. Surgical Intensive Care Unit (SICU), Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33001472

Citation

Zhou, J, et al. "The Effect of Immunonutrition in Patients With Acute Pancreatitis: a Systematic Review and Meta-analysis." Journal of Human Nutrition and Dietetics : the Official Journal of the British Dietetic Association, vol. 34, no. 2, 2021, pp. 429-439.
Zhou J, Xue Y, Liu Y, et al. The effect of immunonutrition in patients with acute pancreatitis: a systematic review and meta-analysis. J Hum Nutr Diet. 2021;34(2):429-439.
Zhou, J., Xue, Y., Liu, Y., Li, X. K., Tong, Z. H., & Li, W. Q. (2021). The effect of immunonutrition in patients with acute pancreatitis: a systematic review and meta-analysis. Journal of Human Nutrition and Dietetics : the Official Journal of the British Dietetic Association, 34(2), 429-439. https://doi.org/10.1111/jhn.12816
Zhou J, et al. The Effect of Immunonutrition in Patients With Acute Pancreatitis: a Systematic Review and Meta-analysis. J Hum Nutr Diet. 2021;34(2):429-439. PubMed PMID: 33001472.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of immunonutrition in patients with acute pancreatitis: a systematic review and meta-analysis. AU - Zhou,J, AU - Xue,Y, AU - Liu,Y, AU - Li,X K, AU - Tong,Z H, AU - Li,W Q, Y1 - 2020/10/01/ PY - 2020/08/08/revised PY - 2020/07/06/received PY - 2020/08/17/accepted PY - 2020/10/2/pubmed PY - 2020/10/2/medline PY - 2020/10/1/entrez KW - acute pancreatitis KW - enteral nutrition KW - meta-analysis KW - parenteral nutrition KW - randomized controlled trials SP - 429 EP - 439 JF - Journal of human nutrition and dietetics : the official journal of the British Dietetic Association JO - J Hum Nutr Diet VL - 34 IS - 2 N2 - BACKGROUND: The effect of immunonutrition is controversial compared to standard supplementation with respect to the management of patients with acute pancreatitis. METHODS: An online literature search on four databases (PubMed, Cochrane, Embase and Web of Science) was performed to identify all of the randomised controlled trials assessing the effects of enteral or parenteral immunonutrition in acute pancreatitis. A fixed or random effects model was chosen using revman, version 5.3 (https://revman.cochrane.org). The count data were analysed using the risk ratio (RR) and 95% confidence interval (CI). RESULTS: Five hundred and sixty-eight patients were included via our search in which 14 articles matched our criteria for enrolling the meta-analysis. Immunonutrition significantly reduced the risk of organ failure (RR = 0.42; 95% CI = 0.26-0.70, P = 0.0008), infectious complications (RR = 0.78; 95% CI = 0.62-0.99; P = 0.04) and mortality (RR = 0.37; 95% CI = 0.21-0.66; P = 0.006). Length of hospital stay was also shorter in patients who received immunonutrition (mean difference = -1.73 days; 95% CI = -2.36 to -1.10; P < 0.00001). Total interventions of patients were decreased (RR = 0.73; 95% CI = 0.55-0.97; P = 0.03). Body mass index in patients with immunonutrition was reduced more than standard nutrition (mean difference = -2.00; 95% CI = -3.96 to -0.04; P = 0.05). CONCLUSIONS: Immunonutrition support such as glutamine and ω-3 fatty acids is potentially beneficial with respect to improving clinical outcomes in patients with acute pancreatitis. SN - 1365-277X UR - https://www.unboundmedicine.com/medline/citation/33001472/The_effect_of_immunonutrition_in_patients_with_acute_pancreatitis:_a_systematic_review_and_meta_analysis_ DB - PRIME DP - Unbound Medicine ER -
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