meta-analysis·clinical nutrition, gastroenterology, critical care, meta-analysis, systematic review·PMC10615524
Efficacy of immune nutrients in severe acute pancreatitis: A network meta-analysis
Medicine · 4 authors, 2 centres
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This network meta-analysis of 19 randomized controlled trials with 1035 patients compared the effects of different immune nutrients in severe acute pancreatitis. Parenteral glutamine was the only intervention significantly associated with reduced mortality and infection compared to control, while both parenteral glutamine and parenteral omega-3 polyunsaturated fatty acids were associated with reduced hospital stay, ICU stay, and C-reactive protein levels.
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This network meta-analysis included 19 randomized controlled trials with 1035 patients evaluating immune nutrients (glutamine, omega-3 PUFAs, arginine, nucleotides) administered enterally or parenterally in severe acute pancreatitis. Outcomes assessed were mortality, infection, LOH, LOI, and CRP. Parenteral omega-3 PUFAs significantly reduced LOH (MD −6.77 days), LOI (MD −5.19 days), and CRP (MD −26.20 mg/L) but not mortality or infection. Limitations include low overall study quality, few double-blind designs, small study numbers for some interventions (EN-Gln + Arg had only one study), and indirect comparisons between immune nutrient groups. The authors concluded that parenteral administration may be superior to enteral administration in this population.
