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Nutritional support in critically ill patients

J P Grant1

  • 1Department of Surgery, Duke University Medical Center, Durham, NC 27710.

Annals of Surgery
|November 1, 1994
PubMed
Summary
This summary is machine-generated.

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Newer nutritional substrates like medium-chain fatty acids, branched-chain amino acids, and glutamine offer clinical benefits for critically ill patients. Further research is ongoing for other substrates as potential pharmacologic agents to improve patient outcomes.

Area of Science:

  • Clinical Nutrition
  • Critical Care Medicine
  • Nutritional Biochemistry

Background:

  • Artificial nutrition support has advanced significantly over the last 25 years.
  • Current enteral and parenteral access methods facilitate non-volitional feeding.
  • Research focuses on optimizing nutritional formulations and exploring specialized nutrients as pharmacologic agents.

Purpose of the Study:

  • To review emerging nutritional substrates for enteral and parenteral nutrition.
  • To evaluate the potential of these substrates as caloric sources and pharmacologic agents.
  • To discuss their role in managing critically ill patients and augmenting host defenses.

Main Methods:

  • Review of pertinent laboratory and clinical data.
  • Analysis of the advantages and disadvantages of various nutritive substrates.

Related Experiment Videos

  • Synthesis of current evidence on specialized nutrients.

    • Main Results:

    • Medium-chain fatty acids, branched-chain amino acids, and glutamine demonstrate clinical benefits.
    • Short-chain fatty acids are still under investigation.
    • Albumin, vitamins E and C, arginine, glutamine, and omega-3 fatty acids show promise as immunomodulators.

    Conclusions:

    • Medium-chain fatty acids, branched-chain amino acids, and glutamine are recommended for clinical use.
    • Certain substrates show potential as pharmacologic agents to modulate the stress response in critical illness.
    • Nucleotides remain investigational for clinical application.