Critical Care and Shock

Immunonutrition: current status


Nutritional support is now recognized as an essential component of care in all critically ill patients. Malnourished patients suffer from generalized reduction in both cellular and humoral immunity. Certain nutrients and their deficiencies may have specific effects upon the immune systems. Malnutrition and stress depresses immune system, adequate nutrition reverses this effect. Prevention of infection is a primary end-point of all nutritional support. Early enteral nutrition has gained increasing popularity due to host’s immune response, maintenance of gut integrity and of course its lower costs. Animal studies have shown that fasting, injury and infection can lead to gut atrophy and increased mucosal permeability [1]. Bacterial translocation is linked to the development of post-operative sepsis and multiple organ failure [2,3].

The basic aims of immunonutrition are to modulate the immune response with naturally occurring nutrients so as to curb tissue injury, reduce infection rates and morbidity, and so eventually improve survival. Numerous clinical trials and three meta-analyses suggest that immunonutrition can be beneficial in specific groups of patients.

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