Immunonutrition beschreibt den additiven Einsatz verschiedener immunologisch aktiver Substanzen in Sondennahrung. Hierzu zählen im Besonderen die Aminosäuren Glutamin und Arginin sowie n-3-Fettsäuren und Nukleotide. In metabolischen und klinischen Studien konnten die Resorption und immunologische Aktivität bei kritisch Kranken nachgewiesen werden. Bei zwei Metaanalysen ergaben sich positive Einflüsse auf den Krankheitsverlauf bei postoperativen Trauma- und internistischen Intensivpatienten. Die enterale Immunonutrition erfüllt damit die härtesten Kriterien der „evidence-based medicine”.
Abstract
Immunonutrition involves the addition of specific nutrients known to have immunomodulating activity, to enteral nutrition, including the amino acids glutamine and arginine as well as n-3 fatty acids and nucleotides. It has been demonstrated in metabolic and clinical trials, that these immunonutrients are resorbed and that they are immunologically active in critically ill patients. Two meta-analyses further revealed that the use of immunonutrition positively influences the course of illness in postoperative, traumatised and internistically critically ill patients. Hence, enteral immunonutrition fulfills the most severe criteria of „evidence-based medicine”.
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