PP077 - MICRONUTRIENT AND ANTIOXIDANT SUPPLEMENTATION IN CRITICALLY ILL ADULTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

PP077

MICRONUTRIENT AND ANTIOXIDANT SUPPLEMENTATION IN CRITICALLY ILL ADULTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

J. G. Lee¹, J. Jeong^1,*, J. Y. Jeong², S. M. Baik¹, H. J. Shim¹

¹Surgery, ²Clinical Nutrition, Ewha Womans University Mokdong Hospital, Seoul, Korea, Republic Of

Rationale: Micronutrient deficiencies are common in critically ill patients and may worsen outcomes. However, the benefit of supplementation beyond standard care remains uncertain.

Methods: We conducted a systematic review of PubMed, Embase, Cochrane Library, and KoreaMed (2010–2025). Randomized controlled trials evaluating micronutrient or antioxidant supplementation in critically ill adults were included. Random-effects meta-analysis was conducted. Effect estimates for binary outcomes were expressed as risk ratios (RRs). Outcomes included mortality, infections, organ dysfunction, and length of stay.

Results: A total of 64 randomized trials were included. Supplementation reduced 28/30-day mortality (RR 0.82, 95% confidence interval [CI] 0.68–1.00), while ICU and hospital mortality were unchanged. Infection rates were not significantly reduced, but pneumonia and ventilator-associated pneumonia were decreased (RR 0.61, 95% CI 0.46–0.81). ICU length of stay and Sequential Organ Failure Assessment scores were improved. Analyses by individual micronutrients showed no consistent benefits. The apparent effects were largely driven by vitamin C, which was associated with reduced short-term mortality, pneumonia, and duration of mechanical ventilation. Subgroup analyses showed survival benefit confined to surgical populations, mainly cardiac surgery patients (RR 0.38, 95% CI 0.15–0.98), with no mortality reduction in sepsis or respiratory failure populations. A signal toward increased need for renal replacement therapy was observed.

Image:

Conclusion: Micronutrient supplementation cannot be routinely recommended in critically ill adults, as benefits are not consistent across individual nutrients.

Disclosure of Interest: None declared