The quality of evidence is downgraded by study limitations (lack of/unclear allocation concealment and lack of blinding).
A Cochrane review [Abstract] 1 included 17 studies with a total of 632 subjects of at least 2 weeks of nutritional support. There was no significant difference in final weight between those who received supplementation and those who did not (MD 0.69 kg, 95% CI -0.86 to 2.24; 14 studies, n=512, nourished and undernourished subjects). In undernourished patients, pooled data found a statistically significant weight gain (MD 1.65 kg, 95% CI 0.14 to 3.16; 11 studies, n=325) in favour of supplementation. When analysed as change from baseline, there was significant improvement with supplementation (MD 1.62 kg, 95% CI 1.27 to 1.96; 14 studies, n=511, nourished and undernourished subjects; and MD 1.73 kg, 95% CI 1.29 to 2.17; 11 studies, n=324, malnourished).
There was no significant difference between groups in the 6-minute walk distance (MD 14.05 m, 95% CI -24.75 to 52.84; 5 studies, n=142), 12-minute walk distance or in shuttle walking. However, the pooled change from baseline for the 6-minute walk distance was significant (MD 39.96 m, 95% CI 22.66 to 57.26; 5 studies, n=140).There was no significant difference between groups in the FEV1.There was no significant between group difference in maximum inspiratory pressure (MIP; MD 3.54 cm H2O, 95% CI -0.90 to 7.99; 9 studies, n=245), but those who received supplementation had a higher maximum expiratory pressure (MEP; MD 9.55 cm H2O, 95% CI 2.43 to 16.68; 9 studies, n=245). For malnourished patients (7 studies, n=189), those with supplementation had significantly better MIP (MD 5.02, 95% CI 0.29 to 9.76) and MEP (MD 12.73, 95% CI 4.91 to 20.55).
Primary/Secondary Keywords