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Immunonutrition and enteral hyperalimentation of critically ill patients

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Abstract

Physicians need to be maximally aggressive in their use of total enteral nutrition (TEN) in the critically ill patient, due to its lower cost, better physiology, and lower complication rate when compared to parenteral therapy. Various components in TEN such as glutamine, arginine, RNA nucleotides, omega-3 fish oils, and fiber, may have important roles in immunonutrition by maintaining gut integrity, stimulating the immune system, and preventing bacterial translocation from the gut. For each patient, the physician must choose the optimal enteral formula for that particular disease or organ failure state to maximize nutrient substrate assimilation and tolerance. Total parenteral nutrition (TPN) should be used only when a true contraindication to enteral feedings exists or as adjunctive therapy when full nutritional requirements cannot be met by TEN alone.

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Authors and Affiliations

  1. Division of Gastroenterology/Hepatology, Department of Medicine, University of Louisville School of Medicine, 40292, Louisville, Kentucky

    Stephen A. McClave MD, Cynthia C. Lowen RD, CNSD & Harvy L. Snider MD

  2. Veterans Affairs Medical Center, 40292, Louisville, Kentucky

    Stephen A. McClave MD, Cynthia C. Lowen RD, CNSD & Harvy L. Snider MD

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  1. Stephen A. McClave MD
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  2. Cynthia C. Lowen RD, CNSD
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  3. Harvy L. Snider MD
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McClave, S.A., Lowen, C.C. & Snider, H.L. Immunonutrition and enteral hyperalimentation of critically ill patients. Digest Dis Sci 37, 1153–1161 (1992). https://doi.org/10.1007/BF01296554

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