Immunonutrition with omega-3 fatty acids or antioxidants for acute respiratory distress syndrome (ARDS) in adults
Citation: Dushianthan A, Cusack R, Burgess VA, et al. Immunonutrition for acute respiratory distress syndrome (ARDS) in adults. Cochrane Database of Systematic Reviews 2019; (1): CD012041.
What is this? Some patients with COVID-19 will develop acute respiratory distress syndrome (ARDS), and may need mechanical ventilation (MV) to help with their breathing. ARDS is an overwhelming systemic inflammatory process associated with significant morbidity and mortality. Immunonutrition, given as part of a feeding formula or as a nutritional supplement, might be used as part of its treatment.
In this Cochrane systematic review, the authors searched for randomized trials of the effects of immunonutrition on adults with ARDS who are receiving MV. They did not restrict by language of publication and did their searches in April 2018. They identified 10 studies (1015 participants), but these did not assess any form of immunonutrition other than omega‐3 fatty acids and antioxidants.
What works: Nothing reported.
What doesn’t work: There was no mortality benefit associated with use of omega‐3 fatty acids or antioxidants in adults with ARDS.
What’s uncertain: It is uncertain whether using omega-3 fatty acids or antioxidants as part of nutritional intake in patients with ARDS) reduces the length of ICU stay or time on MV, improves oxygenation or increases adverse outcomes.
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