Immunonutrition in Acute Respiratory Distress Syndrome

摘要

Purpose of Review Dietary supplementation with nutrients such as glutamine and omega-3 fatty acids to modulate/boost host immunity in critical illness is a new concept. We review current evidence (animal and human studies) on the role of immunonutrition in acute respiratory distress syndrome (ARDS). Recent Findings Dietary supplementation during stress states (ARDS) with omega-3 fatty acids has been shown to attenuate inflammation and improve lung microvascular permeability in animals. In humans, omega-3 fatty acid supplementation has shown mixed results. While studies show improvement in oxygenation and lung mechanics, a recent study demonstrated increased mortality with omega-3 fatty acids. Similarly, animal studies suggest that lower glutamine levels are associated with worse outcomes in surgical and septic patients. But, a recent study in humans has shown an increased trend towards all-cause mortality. Summary Current evidence is conflicting and does not support use of immune-modulating therapies (glutamine or omega-3 fatty acids) in ARDS.