Current opinion in clinical nutrition and metabolic care
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Curr Opin Clin Nutr Metab Care · Mar 2003
ReviewNutrition support in critically ill septic patients.
Infection and sepsis remain major challenges in the critically ill. How nutritional therapy can effect real clinical outcomes is not easily apparent from the clinical data. Despite reducing infectious incidence, many studies show little difference in meaningful clinical outcomes. ⋯ Encouraging new evidence will help our decision making and shows that outcome can be improved by performing relatively simple therapies well.
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Curr Opin Clin Nutr Metab Care · Mar 2003
ReviewImmune-enhancing diets for stressed patients with a special emphasis on arginine content: analysis of the analysis.
After two decades of intensive research, whether arginine-enriched diets for oral/enteral administration are beneficial or harmful for stressed patients remains uncertain. An American consensus and a meta-analysis provide divergent conclusions. The main goal of the present review is to analyze these documents. ⋯ In light of the current doubts and until convincing data are produced, immune-enhancing diets should not be used in unstable critically ill patients.
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Curr Opin Clin Nutr Metab Care · Mar 2003
ReviewRole of L-glutamine in critical illness: new insights.
This review will attempt to summarize recent clinical and experimental data on glutamine's use in critical illness. It will try to present the concept of glutamine as a 'drug' or 'nutraceutical', given in addition to standard nutritional support. ⋯ High-dose or parenteral (>0.20-0.30 g/kg/day or > or =30 g/day) glutamine appears to demonstrate the greatest potential for benefit in critically ill patients. No evidence of harm has been observed in studies conducted to date, thus further clinical trials utilizing glutamine as a pharmacologic supplement to standard nutrition are warranted.