How to feed patients with sepsis.

Area of Science:

• Critical Care Medicine
• Nutritional Science
• Immunology

Background:

• Sepsis induces significant catabolism and hypermetabolism, driven by inflammatory mediators.
• Metabolic alterations in sepsis are not fully reversible through nutritional interventions alone.
• Nutritional therapy can influence sepsis incidence and progression, with hyperglycemia and certain fat emulsions potentially increasing infection risk.

Purpose of the Study:

• To review the complex interplay between sepsis, nutritional support, and immune function.
• To evaluate the impact of different nutritional strategies on infectious complications in sepsis.
• To explore the potential benefits of immunonutrition in critically ill septic patients.

Main Methods:

• Literature review of studies on sepsis pathophysiology and nutritional management.
• Analysis of research on the effects of hyperglycemia and intravenous fat emulsions on infection.
• Examination of evidence regarding enteral nutrition versus parenteral nutrition in critical illness.
• Review of studies investigating novel immunonutritional formulations and their impact on immunity.

Main Results:

• High-protein, isocaloric nutritional regimens are recommended alongside sepsis management.
• Enteral nutrition is linked to fewer infectious complications compared to parenteral nutrition.
• Emerging evidence suggests immunonutrition may reduce infection risk and potentially improve survival in sepsis.

Conclusions:

• Nutritional support in sepsis is complex, requiring careful consideration of metabolic changes and potential complications.
• Immunonutrition represents a promising area for enhancing immune defense and improving outcomes in critically ill septic patients.
• Further research is warranted to fully elucidate the role of immunonutrition in sepsis management.