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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
NUTRITIONAL STATUS AND IMMUNOLOGICAL COMPETENCE
Minerva Anestesiologica 2000 May;66(5):362-6
Rational base and clinical results of immunonutrition
Gentilini O., Braga M., Gianotti L.
From the Department of Surgery IRCCS S. Raffaele Hospital, Milano
The use of enteral formulas supplemented with immunonutrients has been demonstrated to modulate gut function, inflammatory and immune response after trauma in both experimental and clinical settings. Most studies have focused on glutamine, arginine, w-3 fatty acids and nucleotides. Glutamine is an important source of nitrogen and calories and might be particularly useful in depleted patients or in patients affected by small bowel syndrome. Its use in the critical patient remains controversial. Data collected in two different recent meta-analysis consistently confirmed that enteral formulas enriched with, arginine, w-3 fatty acids and nucleotides reduced infectious complications and hospital stay after planned surgery, and decreased infectious complications, hospital stay and ventilator days in the critically ill. Mortality seems not to be affected by enteral administration of immunonutrients.