NEW INSIGHTS ABOUT THE EFFECT OF IMMUNO-NUTRITION ON THE OUTCOME OF THE SERIOUSLY ILL PATIENT, A NARRATIVE REVIEW
Andrea Paola Rojas Hill
Friday, April 1, 2022
Publication year:
2022
Author:
- Rojas Hill Andrea Paola, .Department of Nursing, Faculty of Health Sciences, University of Peloponnese, Tripoli, Greece
Keywords index:
Pages: 161-170
Abstract:
Background: Acute illness is associated with hypercatabolic state, immunosuppression and inflammation. The role of immuno-nutrition (IN) in critically ill patients is still controversial although the use of immunomodulators has been shown to be beneficial. The purpose of this study was to explore the effect of immuno-nutrition on the outcome of the seriously ill patient. Methods: A 2000-2021 literature review was performed to analyze and evaluate the scientific base evidence for the use of immune nutrients (such as arginine, glutamine, omega-3 fatty acids and antioxidants) in critically ill patients including COVID-19 infected patients. The review includes randomized controlled trial studies, systematic reviews and meta-analyses. Results: IN has been shown to improve immune suppression, inflammatory responses, mucosal barrier function and cellular defense function. Supplementing micronutrients could also act as metabolic support. Benefits are mainly concerning the effect on mortality, reduction in infectious morbidity in hemodynamic stable patients, significant reduction in the duration of respiratory engineering support, infection-related mortality, and length of hospital stay. IN formulas can mainly be used in certain groups of critically ill patients (severely gastrointestinal patients) in patients with burns, head or neck cancer, and in patients with mechanical respiratory support) and with caution in patients with severe sepsis. Concerning the COVID-19 infected patients there are not enough data on efficacy and safety.Conclusions: The mechanism by which IN modulates immune function and tissue repair processes is somewhat selective and may depend on metabolic, genetic, or environmental influences. It is still necessary to determine which are the most effective mixtures of immune elements, which nutrients are unnecessary and which nutrients can even prove harmful.
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