Georgieff M, Tugtekin I F
Universitätsklinik für Anästhesiologie, Ulm, Germany.
Kidney Int Suppl. 1998 Feb;64:S80-3.
Critically ill patients with systemic inflammatory response syndrome (SIRS) and multi-organ failure are at great risk of nosocomial infections due to a reduced immune status. There is growing evidence from in vitro studies and animal models that the reduced immune response might be improved by the so-called immunomodulatory nutrition. Based on these studies there are now some commercially available enteral or parenteral solutions with immunomodulatory substrates, such as n-3 polyunsaturated fatty acids (PUFAs), arginine and nucleotides. Recently, enteral nutrition with this experimental formula reduced the hospital length of stay and the frequency of acquired infections in critically ill patients. The increasing knowledge about the metabolic effects of these nutritions offers therapeutic potential for the future, and might reduce the mortality of critically ill patients from nosocomial infections. However, at present, studies are necessary to find the best time for beginning and duration of the feeding. In addition, the optimal dosage and composition of these pharmacologically active substances has to be investigated.
患有全身炎症反应综合征（SIRS）和多器官功能衰竭的重症患者由于免疫状态降低，发生医院感染的风险很高。体外研究和动物模型越来越多地证明，所谓的免疫调节营养可能会改善免疫反应降低的情况。基于这些研究，现在有一些含有免疫调节底物的市售肠内或肠外营养制剂，如n-3多不饱和脂肪酸（PUFA）、精氨酸和核苷酸。最近，使用这种实验配方进行肠内营养可缩短重症患者的住院时间并降低获得性感染的发生率。对这些营养物质代谢作用的了解不断增加，为未来提供了治疗潜力，并可能降低重症患者因医院感染导致的死亡率。然而，目前有必要进行研究以确定开始喂养的最佳时间和持续时间。此外，还必须研究这些药理活性物质的最佳剂量和组成。
