Immune modulating nutrients may modulate pathophysiological processes in critical illnes, such as inflammatory and oxidative stress responses and impaired cellular immune functions.
Includes nutrients such as glutamine, nucleic acids, omega-3 fatty acids, arginine, selenium,and anti-oxidants.
Meta-analyses suggest the use of the immune-modulating nutrients in enteral nutrition is associated with reductions in infectious morbidity and improves recovery from critical illness when compared with standard enteralnutrition.
In a randomized double-blind multicentric trial including a six-month follow-up in 14 intensive care units a total of 301 patients who were being ventilated from more than 72 hours and required nutrition for more than 72 hours were randomized to high-protein immune-modulated or high-protein enteral nutrition: among adult patients on mechanical ventilation in the ICU IMHP did not improve infectious complications or other clinical endpoints and maybe harmful with increased adjusted mortality at six months (van Zanten AR et al).