Gentilini O, Braga M, Gianotti L
Department of Surgery, IRCCS S. Raffaele Hospital, Milano.
Minerva Anestesiol. 2000 May;66(5):362-6.
The use of enteral formulas supplemented with immunonutrients has been demonstrated to modulate gut function, inflammatory and immune response after trauma in both experimental and clinical settings. Most studies have focused on glutamine, arginine, w-3 fatty acids and nucleotides. Glutamine is an important source of nitrogen and calories and might be particularly useful in depleted patients or in patients affected by small bowel syndrome. Its use in the critical patient remains controversial. Data collected in two different recent metaanalysis consistently confirmed that enteral formulas enriched with, arginine, w-3 fatty acids and nucleotides reduced infectious complications and hospital stay after planned surgery, and decreased infectious complications, hospital stay and ventilator days in the critically ill. Mortality seems not to be affected by enteral administration of immunonutrients.
在实验和临床环境中，使用添加免疫营养素的肠内营养配方已被证明可调节创伤后的肠道功能、炎症和免疫反应。大多数研究集中在谷氨酰胺、精氨酸、ω-3脂肪酸和核苷酸上。谷氨酰胺是氮和热量的重要来源，可能对营养缺乏的患者或患有小肠综合征的患者特别有用。其在危重症患者中的使用仍存在争议。最近两项不同的荟萃分析收集的数据一致证实，富含精氨酸、ω-3脂肪酸和核苷酸的肠内营养配方可减少择期手术后的感染并发症和住院时间，并减少危重症患者的感染并发症、住院时间和机械通气天数。肠内给予免疫营养素似乎不会影响死亡率。
