ABSTRACT
In recent years, the evolution of formulas containing pharmacologic doses of some nutrients has placed nutrition intervention beyond patient nourishment into the realm of disease prevention and treatment. Immunomodulary components are added to stimulate the immune response, increase wound healing, and, ultimately, decrease morbidity and mortality in the critically ill. The nutrients focused on are primarily glutamine, arginine, omega-3 fatty acids (FAs), and nucleotides. Few studies have been done on the effects of the individual nutrients in the critically ill human, and even fewer dose-response or kinetic studies have been undertaken. Most of the studies involving these nutrients in the critically ill patient population fall into one of two categories:
• Studies of tube feedings, most of which contain more than one immune-modulating agent • Studies of parenteral glutamine
There is no agreement on exactly which combination or dose of nutrients is the “best” combination, and each enteral product marketed as “immune-enhancing” is different from every other product.
