Immune enhancing enteral nutrition reduced mortality and acquired infections in intensive care unit patients with sepsis
QUESTION: Among patients in the intensive care unit (ICU) with sepsis, is immune enhancing enteral feeding more effective than high protein enteral feeding for reducing mortality and subsequent episodes of bacteraemia?
Randomised (unclear allocation concealment), unblinded controlled trial.
6 hospitals in Spain.
181 patients >14 years of age who were admitted to the ICU, had sepsis (positively cultured or clinically diagnosed infection), and had an Acute Physiology and Chronic Health Evaluation (APACHE) II score ≥10. Exclusion criteria were pregnancy, previous radiotherapy, previous treatment with immune enhancing enteral or parenteral nutrition, treatment with immunosuppressive drugs, AIDS, neoplasia, or metastases. Follow up was 97% (mean age 56 y, 73% men).
Patients received enteral feeds by nasoenteric, nasogastric, gastrostomy, or jejunostomy tube. Feeds were started within 36 hours of the diagnosis of sepsis, and …