gamma-linolenic-acid and Pressure-Ulcer

To review the main scientific evidence on nutrition in the prevention and treatment of pressure injuries (PIs) in critically ill adult patients.. The searches were carried out in several scientific databases, namely, Scientific Electronic Library Online (SciELO), Public MEDLINE (PubMed), Latin American and Caribbean Literature in Health Sciences (LILACS), and Web of Science. The MeSH terms used were "pressure injury", "nutrition", and "intensive care".. Studies published between January 1, 2005, and July 1, 2020, were included. Seven studies met the eligibility criteria and were included in this review. The searches were carried out in August 2020. The authors selected studies available in Portuguese, English, and Spanish.. Two independent researchers conducted the searches and read the article titles and abstracts. The studies that met the inclusion criteria were fully evaluated. Disagreements between reviewers were resolved by consensus, and when there was no consensus, a senior researcher was consulted. Data extraction was performed using a standardized form.. Level-of-evidence analysis according to the type of study followed the classification proposed by the Oxford Center Evidence-Based Medicine. The evidence available on the use of standard enteral nutrition therapy and enteral nutrition therapy enriched with hyperprotein and hypercaloric nutrition supplements as well as the addition of zinc, eicosapentaenoic acid, γ-linolenic acid, and vitamins (A, C, D, and E) is limited in terms of supporting a specific nutrition support modality in the prevention and treatment of PI in the intensive care population.. Malnutrition negatively impacts both the prevention and healing of PIs. The evidence available on the use of standard enteral nutrition therapy versus enrichment with nutrition supplements is too limited to support a specific nutrition modality in the prevention and treatment of PI in the intensive care population.

Topics: Critical Illness; gamma-Linolenic Acid; Humans; Nutritional Status; Pressure Ulcer; Vitamins; Zinc

Pressure ulcers are a significant burden in the ICU. Many factors have found to be associated with pressure ulcers including malnutrition. While it has been recognized that high protein diets decrease the incidence of pressure ulcers, the role of lipids as well as vitamins and antioxidants remains unclear. The aim of this study was to evaluate the preventive and healing effects of an enteral diet enriched in eicosapentanoic acid (EPA) and gamma-linolenic acid (GLA) and vitamins (vitamins A, C and E) on pressure ulcers.. One hundred patients with acute lung injury were included in a larger study evaluating the effects of lipids and vitamins on respiratory function. A secondary end point, occurrence and healing of pressure ulcers was included. A diet enriched in lipids (EPA, GLA) and vitamins (vitamins A, C and E) was compared with a diet similar in macronutrient composition. The occurrence and healing of pressure ulcers was evaluated according to the National Pressure Ulcer Panel. Nutritional assessment included calorie intake, resting energy expenditure, levels of serum prealbumin, albumin, vitamins A and E, zinc and copper. C-reactive protein and procalcitonin were also measured.. Patient's age, severity of disease and gender distribution were similar in the two groups. The study group had a higher body mass index. At baseline, the pressure ulcer score was similar in the two groups A significantly lower rate of occurrence of new pressure ulcers was observed in the study group compared to the control group (p<0.05). No difference was observed in the healing of existing pressure ulcers in the study as opposed to the control group. There was no significant difference in the nutritional parameters between the two groups.. A diet enriched with EPA, GLA and vitamins A, C and E is associated with a significantly lower occurrence of new pressure ulcers in critically ill patients with acute lung injury.

Topics: Analysis of Variance; Antioxidants; Ascorbic Acid; Chi-Square Distribution; Critical Illness; Eicosapentaenoic Acid; Female; gamma-Linolenic Acid; Humans; Lung Diseases; Male; Middle Aged; Nutrition Assessment; Nutritional Status; Pressure Ulcer; Prospective Studies; Respiration, Artificial; Severity of Illness Index; Treatment Outcome; Vitamin A; Vitamin E; Vitamins; Wound Healing