Background

• Artificial nutrition is a staple of critical care
• Patients who are unable to eat, require enteral nutrition (preferred over parental nutrition)
• There are some formulas that are called "immunonutrition" which try to alter the inflammatory response seen in critical illness
• They may contain omega-3 fatty acids and essential amino acids such as arginine or glutamine, and anti-oxidants.

Data

• A recent trial (MetaPlus) was designed to see if immunonutrition could decrease the development of infections in the critically ill
• Compared to regular high protein formulas, there was no difference in mortality, duration of ventilation, or hospital length of stay

What to do

• Immuno-nutrition formulas cannot be routinely recommended
• Use regular high protein formulas
• Start within 48 hours of identifying a need

 

References

High-Protein Enteral Nutrition Enriched With Immune-Modulating Nutrients vs Standard High-Protein Enteral Nutrition and Nosocomial Infections in the ICU

A Randomized Clinical Trial