Abstract | INTRODUCTION: METHODS: We searched computerized databases, reference lists of pertinent articles and personal files from 1980 to 2011. We included randomized controlled trials (RCTs) conducted in critically ill adult patients that evaluated relevant clinical outcomes with antioxidant micronutrients ( vitamins and trace elements) supplementation versus placebo. RESULTS: A total of 21 RCTs met inclusion criteria. When the results of these studies were statistically aggregated (n = 20), combined antioxidants were associated with a significant reduction in mortality (risk ratio (RR) = 0.82, 95% confidence interval (CI) 0.72 to 0.93, P = 0.002); a significant reduction in duration of mechanical ventilation (weighed mean difference in days = -0.67, 95% CI -1.22 to -0.13, P = 0.02); a trend towards a reduction in infections (RR= 0.88, 95% CI 0.76 to 1.02, P = 0.08); and no overall effect on ICU or hospital length of stay (LOS). Furthermore, antioxidants were associated with a significant reduction in overall mortality among patients with higher risk of death (>10% mortality in control group) (RR 0.79, 95% CI 0.68 to 0.92, P = 0.003) whereas there was no significant effect observed for trials of patients with a lower mortality in the control group (RR = 1.14, 95% 0.72 to 1.82, P = 0.57). Trials using more than 500 μg per day of selenium showed a trend towards a lower mortality (RR = 0.80, 95% CI 0.63 to 1.02, P = 0.07) whereas trials using doses lower than 500 μg had no effect on mortality (RR 0.94, 95% CI 0.67 to 1.33, P = 0.75). CONCLUSIONS:
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Authors | William Manzanares, Rupinder Dhaliwal, Xuran Jiang, Lauren Murch, Daren K Heyland |
Journal | Critical care (London, England)
(Crit Care)
Vol. 16
Issue 2
Pg. R66
(Dec 12 2012)
ISSN: 1466-609X [Electronic] England |
PMID | 22534505
(Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
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Chemical References |
- Antioxidants
- Micronutrients
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Topics |
- Antioxidants
(therapeutic use)
- Critical Illness
- Humans
- Micronutrients
(therapeutic use)
- Oxidative Stress
- Randomized Controlled Trials as Topic
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