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NUTRITIONAL STATUS AND IMMUNOLOGICAL COMPETENCE   Free accessfree

Minerva Anestesiologica 2000 May;66(5):362-6

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Rational base and clinical results of immunonutrition

Gentilini O., Braga M., Gianotti L.

From the Department of Surgery IRCCS S. Raffaele Hospital, Milano


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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.

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