New randomized controlled trials on micronutrients in critical care nutrition: A narrative review

Halim, Zakiah and Huang, Yingxiao and Lee, Zheng-Yii and Lew, Charles Chin Han (2024) New randomized controlled trials on micronutrients in critical care nutrition: A narrative review. Nutrition in Clinical Practice, 39 (5, SI). pp. 1119-1149. ISSN 0884-5336, DOI https://doi.org/10.1002/ncp.11195.

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Abstract

There has been increasing interest in the role of micronutrient supplementation in critical care. This narrative review summarizes the recent studies on micronutrients in critically ill patients. We searched two databases for primary randomized controlled trials that investigated the effects of micronutrient supplementation in patients with critical illness published from January 2021 to August 2023. Personal files, reference lists of included studies, and previous reviews were also screened. Twelve studies reported on vitamin C, four studies on vitamin D, three studies on thiamin, two studies on multivitamins, and one study on cobalamin. The therapeutic effects of vitamin C appear mixed, although vitamin C monotherapy appears more promising than vitamin C combination therapy. Intramuscular administration of vitamin D appeared to lower mortality, mechanical ventilation duration, and intensive care unit stay, whereas enteral administration showed limited clinical benefits. Intravenous thiamin was not associated with improved outcomes in patients with septic shock or hypophosphatemia. Preliminary evidence suggests reduced vasopressor dose with cobalamin. Decreased disease severity and hospital stay in patients with COVID-19 with vitamins A-E requires further investigation, whereas providing solely B-group vitamins did not demonstrate therapeutic effects. It is currently premature to endorse the provision of high-dose micronutrients in critical illness to improve clinical outcomes. This review may help to inform the design of future trials that will help better elucidate the optimal dosage and form of micronutrients, methods of administration, and subgroups of patients with critical illness who may most benefit.

Item Type: Article
Funders: UNSPECIFIED
Uncontrolled Keywords: critical illness; micronutrients; nutrition support; vitamins
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine > Anaesthesiology Department
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 10 Apr 2025 03:53
Last Modified: 10 Apr 2025 03:53
URI: http://eprints.um.edu.my/id/eprint/46679

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