Micronutrient supplementation for critically ill adults: a systemic review and meta-analysis

This systematic review assessed the effects of micronutrient supplementation on adults recovering from critical illness. Primary outcomes included clinical endpoints (mortality, infectious complications, length of intensive care unit and of hospital stay). Secondary outcomes included descriptions of practice issues, micronutrient status, morbidity, course of the acute-phase response, and oxidative stress. Electronic bibliographic databases, bibliographies of retrieved articles, and personal files were searched and reviewed. Randomized controlled trials (RCTs) of micronutrient supplementation in adult critically ill patients administered enterally and/or parenterally in addition to their routine care were included. Two authors independently extracted data and assessed trial quality. The random-effects model was used to estimate overall relative risk (RR)/mean difference and effect size. P < 0.05 was considered statistically significant. Fifteen (n = 1714) and 18 (n = 1849) RCTs were included for the primary and secondary objectives, respectively. The secondary outcomes confirmed that timing, duration, and dosing appear to be key factors to ensure optimal clinical benefit. This review does suggest a potential benefit of micronutrient supplementation in critically ill adults by possibly being associated with a decrease in mortality.