A recent study examining the complications that arise based on how nutrition is given to intensive care unit (ICU) patients found no significant differences in infections between patients receiving an enriched feeding tube versus a standard high-protein diet.
Among mechanically ventilated ICU patients, receiving high-protein nutrition through a feeding tube enriched with immune-modulating nutrients (like glutamine, omega-3 fatty acids, and antioxidants) versus a standard high-protein diet did not result in a significant difference in the incidence of new complications and may be harmful, as suggested by an increased risk of death at 6 months.
Arthur R. H. van Zanten, MD, PhD, of the Gelderse Vallei Hospital, Ede, the Netherlands, and colleagues randomly assigned 301 adult ICU patients who were expected to be ventilated and to require enteral nutrition for more than 72 hours to either immune-modulating nutrients or high-protein enteral nutrition. The patients were from 14 ICUs in the Netherlands, Germany, France, and Belgium. Patients were followed for up to six months.
The study, published in JAMA, found that there were no significant differences in the incidence of new infections between groups. Overall, 53% of those in the immune-modulating group had new infections, and 52% in the high-protein group had new infections.
Between the two groups, there were no significant differences in outcomes such as mechanical ventilation duration, ICU and hospital lengths of stay, and a measure of organ failure. The 6-month mortality rate was higher in the medical subgroup: 54% in the immune-modulating group versus 35% in the high-protein group.
“These findings do not support the use of high-protein enteral nutrition enriched with immune-modulating nutrients in these patients,” the authors conclude.