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The Safety of Arginine in the Critically Ill Patient: What Does the Current Literature Show?

  • Gastroenterology and Nutrition (SA McClave, Section Editor)
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Abstract

Arginine, a semi-essential amino acid, is found to decrease under several conditions of critical illness, either due to decreased intake, mucosal absorption or de novo synthesis, and/or concomitantly increased demand. Under stressful situations, several metabolic, inflammatory, and immunological pathways are also triggered, impacting how nutrients may be utilized. In particular, arginine may be degraded by arginase or nitric oxide synthase, leading to different end products which per se influence the patient’s hemodynamic status and response to pathogens. Furthermore, the critically ill patient undergoes a variety of insults that may be marked solely by a physiological response to trauma (e.g., the major gastrointestinal surgical patient) or a more complicated scenario marked by severe sepsis. Nonetheless, several animal and clinical studies have addressed the various critically ill conditions and concluded that supplemental arginine appears safe and potentially beneficial. Several questions still need to be addressed regarding optimal dosing and timing of delivery.

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Compliance with Ethics Guidelines

Conflict of Interest

Maria Isabel Toulson Davisson Correia has received compensation from Abbott Nutrition, Nestlé Nutrition, Baxter Nutrition and Fresenius Kabi for service as a consultant and advisory board.

Robert G. Martindale has received compensation from Metagenics, Nestlé, and Abbott Laboratories for service as a consultant.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Universidade Federal de Minas Gerais, Av. Carandaí 246, Apt. 902, Belo Horizonte, MG, 30130-060, Brazil

    Maria Isabel Toulson Davisson Correia

  2. Department of Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mailcode L223A, Portland, OR, 97239, USA

    Robert G. Martindale

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  1. Maria Isabel Toulson Davisson Correia
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  2. Robert G. Martindale
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Correspondence to Maria Isabel Toulson Davisson Correia.

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This article is part of the Topical Collection on Gastroenterology and Nutrition

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Correia, M.I.T.D., Martindale, R.G. The Safety of Arginine in the Critically Ill Patient: What Does the Current Literature Show?. Curr Nutr Rep 4, 230–235 (2015). https://doi.org/10.1007/s13668-015-0134-6

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  • DOI: https://doi.org/10.1007/s13668-015-0134-6

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