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2005, Number 5-6

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Med Crit 2005; 19 (5-6)

Immunonutrition: achievements and promises

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

Language: Spanish
References: 57
Page: 183-193
PDF size: 133.92 Kb.


ABSTRACT

The problems in the appropriate regulation of the immunologic operation observed in critically ill patients offers us an answer in the maintenance of the syndrome of systemic inflammatory response. The feeding lack either enteral when it is possible or parenteral but without the additional supplements explains the bacteriemia origin in critically ill patients by means of bacterial translocation at intestinal level. The complementary use of some nutrients has demonstrated that they favor an immunomodulation. It maintain the good operation of the intestinal epithelium, the lymphoid tissue associated to the intestine and improve the function of T cells. The nutrients studied are glutamine, arginine, omega-3 fatty acids and nucleic acids. It have been carried out many large studies with the purpose of determining the utility of this type of diets. The results are contradictory. It is important to remember that this type of diets needs a time of minimum use and a daily minimum feeding so that they are useful and be justified the cost of its administration. At present although with contradictory results, it exists evidence of a favorable evolution of the selected patients that receive this kind of nutrition. Finally, the role of immunonutrition is the modulation of the immune answer and not to improve the nutritional state.


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