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Meta-Analysis
. 2015 Jul 9;7(7):5572-85.
doi: 10.3390/nu7075239.

Enteral Immunomodulatory Diet (Omega-3 Fatty Acid, γ-Linolenic Acid and Antioxidant Supplementation) for Acute Lung Injury and Acute Respiratory Distress Syndrome: An Updated Systematic Review and Meta-Analysis

Congcong Li  1 , Liyan Bo  2 , Wei Liu  3 , Xi Lu  4 , Faguang Jin  5
Affiliations
Meta-Analysis

Enteral Immunomodulatory Diet (Omega-3 Fatty Acid, γ-Linolenic Acid and Antioxidant Supplementation) for Acute Lung Injury and Acute Respiratory Distress Syndrome: An Updated Systematic Review and Meta-Analysis

Congcong Li et al. Nutrients. .

Abstract

Enteral immunomodulatory nutrition is considered as a promising therapy for the treatment of acute lung injury and acute respiratory distress syndrome (ALI/ARDS). However, there are still some divergences, and it is unclear whether this treatment should be recommended for patients with ALI/ARDS. Therefore, we conducted this systematic review and meta-analysis to assess the efficacy and safety of an enteral immunomodulatory diet on the clinical outcomes of ALI/ARDS patients.

Methods: We retrieved potentially relevant clinical trials though electronic databases. All trials of enteral immunomodulatory diet for ALI/ARDS were included. Analyses of the overall all-cause mortality, 28-day ventilator-free days and 28-day intensive care unit (ICU) free days were conducted.

Results: In total six controlled trials were evaluated. The pooled results did not show a significant reduction in the risk of all-cause mortality (M-H RR (the overall Mantel-Haenszel relative risk), 0.81 (95% CI, 0.50-1.31); p = 0.38; 6 trials, n = 717) in ALI/ARDS patients treated with the immunomodulatory diet. This treatment also did not extend the ventilator-free days and ICU-free days. However, patients with high mortality might benefit from this treatment.

Conclusions: The enteral immunomodulatory diet could not reduce the severity of the patients with ALI/ARDS. Whereas, for ALI/ARDS patients with high mortality, this treatment might reduce the all-cause mortality, but its use should be treated with discretion.

Keywords: acute lung injury; acute respiratory distress syndrome; critical care; enteral nutrition; immunomodulatory diet; mortality.

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Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Flow Diagram.
Figure 2
Figure 2
Forest plot of the association between enteral immunomodulatory diet and all-cause mortality among patients with ALI (acute lung injury)/ARDS (acute respiratory distress syndrome).
Figure 3
Figure 3
Forest plot of the association between enteral immunomodulatory diet and all-cause mortality among patients with ALI/ARDS, stratified by discrepancy of mortality.
Figure 4
Figure 4
Forest plot of the association between enteral immunomodulatory diet and 28-day ventilator-free days among patients with ALI/ARDS.
Figure 5
Figure 5
Forest plot of the association between enteral immunomodulatory diet and 28-day ICU-free days among patients with ALI/ARDS.
Figure 6
Figure 6
Forest plot of the association between enteral immunomodulatory diet and adverse events among patients with ALI/ARDS.
See this image and copyright information in PMC

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