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ISSN 2448-8909 (Impreso)

2005, Número 5-6

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Med Crit 2005; 19 (5-6)


Inmunonutrición: Logros y promesas

Duarte MJ, Díaz MS, Vargas GRB, Rubio GJ, Fernández PL, Lee Eng CVE

Idioma: Español
Referencias bibliográficas: 57
Paginas: 183-193
Archivo PDF: 133.92 Kb.


RESUMEN

Los problemas en la adecuada regulación del funcionamiento inmunológico observado en pacientes críticamente enfermos, nos explica el mantenimiento del síndrome de respuesta inflamatoria sistémica. La falta de alimentación ya sea enteral cuando es posible, o bien parenteral pero sin los suplementos adicionales, explica el origen de bacteriemias en pacientes críticos mediante la translocación bacteriana a nivel intestinal. El uso complementario de algunos nutrientes ha demostrado que favorecen una inmunomodulación, mantienen el buen funcionamiento del epitelio intestinal, del tejido linfoide asociado al intestino y mejoran la función de las células T. Los nutrientes más estudiados a la fecha son la glutamina, arginina, ácidos grasos omega-3 y los nucleótidos. Se han llevado a cabo muchos estudios de metaanálisis con la finalidad de determinar la utilidad de este tipo de dietas. Los resultados son contradictorios. Es importante recordar que este tipo de dietas necesitan un tiempo de uso mínimo y una ingesta mínima diaria para que sean útiles y se justifique el costo de su administración. Actualmente aunque con resultados contradictorios, existe evidencia de una evolución favorable de los pacientes seleccionados que reciben este tipo de nutrición. Finalmente, la inmunonutrición tiene como base la modulación de la respuesta inmune y no mejorar el estado nutricional.


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