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[New nutrients in enteral nutrition].
1Sección de la Unidad de Nutrición, Hospital Ramón y Cajal, Madrid, España.
Nutricion Hospitalaria
|February 28, 2001
Summary
Medical stress increases nutrient needs. Specific "immunonutrients" in enteral formulas can improve immune function and outcomes in critical patients, though mortality benefits are not yet proven.
Area of Science:
- Clinical Nutrition
- Immunology
- Surgical Critical Care
Context:
- Major medical and surgical stress increases the body's demand for essential and non-essential nutrients.
- Certain nutrients, termed "immunonutrients" or "immunity regulators," significantly influence immune function and metabolic indices.
Purpose:
- To review the role of immunonutrients in clinical nutrition and their impact on immune function.
- To evaluate the efficacy of specialized enteral formulas enriched with immunonutrients for critically ill patients.
Summary:
- Nutrients like glutamine, arginine, omega-3 fatty acids, and nucleotides modulate immune responses and improve nutritional status.
- Enteral formulas enriched with these immunonutrients have been increasingly used since 1988 for immunocompromised patients.
- These formulas have demonstrated improvements in infection rates, reduced ventilator days, and shorter hospital stays, particularly in surgical patients.
Impact:
- Evidence supports the use of enriched enteral formulas in critical care, especially for surgical patients.
- While beneficial for infection rates and hospital stay duration, these formulas have not shown a significant reduction in mortality.
- Cautious application according to protocols is recommended for patients with severe catabolism and reduced immunity who are expected to survive.