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Nutritional interventions in patients with burn injury: an umbrella review of systematic reviews and meta-analyses of randomised clinical trials

Published online by Cambridge University Press:  06 November 2024

Fatemeh Naeini Open the ORCID record for Fatemeh Naeini [Opens in a new window] ,
Sheida Zeraattalab-Motlagh Open the ORCID record for Sheida Zeraattalab-Motlagh [Opens in a new window] ,
Mehran Rahimlou Open the ORCID record for Mehran Rahimlou [Opens in a new window] ,
Mahsa Ranjbar ,
Amirhossein Hemmati ,
Sajedeh Habibi ,
Sajjad Moradi Open the ORCID record for Sajjad Moradi [Opens in a new window]  and
Hamed Mohammadi Open the ORCID record for Hamed Mohammadi [Opens in a new window]
Fatemeh Naeini
Affiliation:
Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
Sheida Zeraattalab-Motlagh
Affiliation:
Department of Health and Human Performance, University of Houston, Houston, TX, USA
Mehran Rahimlou
Affiliation:
Department of Nutrition, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
Mahsa Ranjbar
Affiliation:
Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
Amirhossein Hemmati
Affiliation:
Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
Sajedeh Habibi
Affiliation:
Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
Sajjad Moradi
Affiliation:
Department of Nutrition and Food Sciences, Research Center for Evidence-Based Health Management, Maragheh University of Medical Sciences, Maragheh, Iran
Hamed Mohammadi*
Affiliation:
Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
*
*Corresponding author: Hamed Mohammadi, email [email protected], [email protected]
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Abstract

Multiple reviews have examined the impact of nutritional interventions in patients with burn injuries; however, discrepancies among results cast doubt about their validity. We implemented this review to assess the impact of various nutritional interventions in adult patients with burn injuries. We conducted a thorough search of PubMed, Scopus and Web of Science databases until 1 August 2024, to identify relevant meta-analyses of intervention trials, examining the impact of nutritional interventions on burn patients. We adopted the random-effect models to determine the pooled effect sizes while employing the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to examine evidence certainty. Thirty-three original intervention trials from eleven meta-analyses were entered in our review. Early enteral nutrition could substantially reduce overall mortality (relative risk (RR): 0·36, 95 % CI: 0·19, 0·68, GRADE = moderate certainty), hospital stay (mean difference (MD): −15·3, 95 % CI: −20·4, −10·2, GRADE = moderate certainty) and sepsis risk (RR: 0·23, 95 % CI: 0·11, 0·45, GRADE = moderate certainty). Glutamine showed a notable decrease in the length of hospital stay (MD: −6·23, 95 % CI: −9·53, −2·94, GRADE = low certainty). However, other nutritional interventions, including combined immunonutrition, branched-chain amino acids, fish oil, ornithine α-ketoglutarate and trace elements, did not significantly affect the assessed clinical outcomes. Early enteral nutrition might impose a beneficial effect on mortality, hospital stay length and incidence of sepsis with moderate evidence. Lower length of hospital stay was also seen in burn patients supplemented with glutamine, although the evidence was weak.

Keywords

Nutritional interventionMeta-analysisReviewTrialBurnMortality
Type
Review
Information
British Journal of Nutrition , Volume 132 , Issue 10 , 28 November 2024 , pp. 1317 - 1324
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Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of The Nutrition Society

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