Immunonutrition in surgery and critical care

Area of Science:

• Clinical Nutrition
• Critical Care Medicine
• Surgical Nutrition

Background:

• Specialty supplemented enteral diets are used in critically ill, injured, and surgical patients.
• Previous studies suggest benefits, but the specific nutrients responsible are unclear.
• Patient risk stratification is crucial for interpreting efficacy.

Purpose of the Study:

• To review the documented benefits of specialty enteral diets in specific patient populations.
• To highlight the impact on infectious complications.
• To emphasize the importance of individual patient risk assessment.

Main Methods:

• Review of randomized prospective studies on specialty supplemented enteral diets.
• Analysis of patient populations, including critically ill, injured, and surgical patients.
• Evaluation of infectious complications and adverse outcomes.

Main Results:

• Significant reductions in infectious complications observed in certain patient groups.
• Specialty formulas show greatest benefit in patients at risk or with pre-existing malnutrition.
• Safe administration with minimal adverse outcomes reported.

Conclusions:

• Specialty enteral diets offer benefits, particularly in reducing infectious complications for at-risk patients.
• Individualized risk assessment is paramount for optimal use of these diets.
• Despite some controversy, these diets are generally safe for malnourished and critically ill patients.