Uso de fórmula enteral imunomoduladora em pacientes críticos com excesso de peso: revisão sistemática de ensaios clínicos randomizados

Abstract

Critically ill patients with excess weight face additional challenges, including an exacerbated inflammatory response and an increased risk of complications. This metabolic condition heightens the nutritional risk associated with the development of malnutrition. In this context, the growing prevalence of obesity among critically ill patients underscores the need for specific nutritional approaches. This study investigated the effects of immunomodulatory enteral formulas compared to conventional formulas in critically ill overweight adult patients admitted to Intensive Care Units (ICU). A systematic review of the literature was conducted following the methodological guidelines of the Cochrane Handbook for Systematic Reviews of Interventions and reported according to the PRISMA statement. The research protocol was registered in PROSPERO, under the number CRD42023440393. A systematic search was performed in the databases PubMed, Embase, Cochrane Library, Web of Science, Scopus, LILACS, and Scielo, with no language or publication year restrictions. This resulted in the inclusion of one study, a single-center, prospective, randomized, controlled, and open trial, which analyzed the effects of an enteral diet enriched with EPA (Eicosapentaenoic Acid), GLA (Gamma Linolenic Acid) and antioxidants in patients with acute lung injury or acute respiratory distress syndrome. The results indicated significant improvements in oxygenation and reduced mechanical ventilation time in the intervention group. However, the evidence is limited and does not allow definitive conclusions about the clinical benefit of this intervention for the studied population. Therefore, it is recommended to conduct new, well-designed clinical trials, and consequently, evidence-based clinical recommendations.