Current opinion in gastroenterology
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Enteral nutrition is now widely used as the preferred route of nutritional support in malnourished and intensive care unit patients. Studies providing evidence for efficacy, techniques of administration, and outcome are appearing daily in the literature. This review presents evidenced-based studies in this field from December 2002 to the present and critically reviews them for the reader. In this way the reader can rapidly access important publication from the morass being published each year. ⋯ Enteral nutrition is an established modality of nutritional support that has received wide acceptance. It is not clear, however, for which conditions it improves patient outcome and the best way to optimize its delivery. In this review, articles addressing the outcome of patients and methods to optimize delivery of enteral nutrition are reviewed. Unfortunately, with few exceptions, most studies are based on few patients or do not have a placebo arm. An more important flaw in these studies is the nutritional status of the patient and need for support.
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To outline recent findings on the efficacy of immunonutrients in patients undergoing inflammatory stress due to surgery, infection and cancer. ⋯ Immunonutrition is effective in improving outcome in a wide range of patients when applied enterally, particularly in malnourished individuals. Parenteral immunonutrition carries a higher risk but can be efficacious in selected patient groups for whom enteral nutrition is problematic.