Abstract
Purpose of the review: To outline recent findings concerning the efficacy of immunonutrients in patients undergoing surgery. Recent findings: Surgery induces an inflammatory response that can become excessive and damaging in some patients. The major risk factors are pre-existing nutritional status and increasing levels of surgical stress. A range of nutrients, including several amino acids, antioxidant vitamins and minerals, ω-3 fatty acids, and nucleotides, are able to modulate inflammation and the associated oxidative stress, and maintain or improve immune function. Considering the overall treatment effect of immune-modulating nutrients, parenteral glutamine is recommended in patients receiving parenteral nutrition, while enteral glutamine should be considered for burn and trauma patients. Antioxidants, particularly selenium, should be considered for critically ill patients, and enteral formulas enriched with fish oils are recommended for patients with acute respiratory distress syndrome. Arginine-supplemented diets are not recommended. In summary, malnourished patients should receive preoperative artificial nutrition for at least 10 days prior to major surgery and for 7 days postoperatively. Enteral nutrition is the best support for these patients. The benefit of immuneenhancing diets in severely malnourished patients remains to be proven. Preoperative oral immunonutrition (arginine, omega-3 fatty acids, and nucleotides) is indicated for non-malnourished patients. Although patients with cancer exhibit some special metabolic features, preoperative immunonutrition is also indicated. Summary: Immunonutrition is effective in improving outcome in a wide range of patients, particularly in malnourished individuals. However, further research using larger, better-designed trials is needed to assess whether immune function is benefited, with an improved clinical outcome in vulnerable patients.
Current Drug Targets
Title: Immunonutrition in Surgical Patients
Volume: 10 Issue: 8
Author(s): J. Xu, Z. Yunshi and R. Li
Affiliation:
Abstract: Purpose of the review: To outline recent findings concerning the efficacy of immunonutrients in patients undergoing surgery. Recent findings: Surgery induces an inflammatory response that can become excessive and damaging in some patients. The major risk factors are pre-existing nutritional status and increasing levels of surgical stress. A range of nutrients, including several amino acids, antioxidant vitamins and minerals, ω-3 fatty acids, and nucleotides, are able to modulate inflammation and the associated oxidative stress, and maintain or improve immune function. Considering the overall treatment effect of immune-modulating nutrients, parenteral glutamine is recommended in patients receiving parenteral nutrition, while enteral glutamine should be considered for burn and trauma patients. Antioxidants, particularly selenium, should be considered for critically ill patients, and enteral formulas enriched with fish oils are recommended for patients with acute respiratory distress syndrome. Arginine-supplemented diets are not recommended. In summary, malnourished patients should receive preoperative artificial nutrition for at least 10 days prior to major surgery and for 7 days postoperatively. Enteral nutrition is the best support for these patients. The benefit of immuneenhancing diets in severely malnourished patients remains to be proven. Preoperative oral immunonutrition (arginine, omega-3 fatty acids, and nucleotides) is indicated for non-malnourished patients. Although patients with cancer exhibit some special metabolic features, preoperative immunonutrition is also indicated. Summary: Immunonutrition is effective in improving outcome in a wide range of patients, particularly in malnourished individuals. However, further research using larger, better-designed trials is needed to assess whether immune function is benefited, with an improved clinical outcome in vulnerable patients.
Export Options
About this article
Cite this article as:
Xu J., Yunshi Z. and Li R., Immunonutrition in Surgical Patients, Current Drug Targets 2009; 10 (8) . https://dx.doi.org/10.2174/138945009788982432
DOI https://dx.doi.org/10.2174/138945009788982432 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
Related Books

- Author Guidelines
- Bentham Author Support Services (BASS)
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Pomolic Acid Isolated from the Leaves of Licania pittieri Inhibits ADP-and Epinephrine-Induced Platelet Aggregation and has Hypotensive Effect on Rats
Current Bioactive Compounds Tubulin Colchicine Binding Site Inhibitors as Vascular Disrupting Agents in Clinical Developments
Current Medicinal Chemistry Point of NO Return for Nitrergic Nerves in Diabetes: A New Insight into Diabetic Complications
Current Pharmaceutical Design Monoamine Oxidases: to Inhibit or Not to Inhibit
Mini-Reviews in Medicinal Chemistry Cannabinoids
Current Drug Targets - CNS & Neurological Disorders Pharmacological Treatments of Opiate Dependence
Current Pharmaceutical Design Rediscovering Tocophersolan: A Renaissance for Nano-Based Drug Delivery and Nanotheranostic Applications
Current Drug Targets Pharmacovigilance and the Cardiovascular System: Two Sides to Every Story
Current Drug Safety ATP-Sensitive K+ Channels: Current and Putative Target for the Prevention and Treatment of Cardiovascular Diseases
Vascular Disease Prevention (Discontinued) Metabolism and Mechanism of Human Cytochrome P450 Enzyme 1A2
Current Drug Metabolism Review of Topiramate: An Antiepileptic for the Treatment of Alcohol Dependence
Current Drug Abuse Reviews Preface [Hot Topic: Exogenous Factors Affecting Cardiovascular and Hematological Targets (Guest Editor: R. Manjunatha Kini)]
Current Drug Targets - Cardiovascular & Hematological Disorders Current Evidence Regarding Low-carb Diets for The Metabolic Control of Type-2 Diabetes
Current Diabetes Reviews Bcl-2 Proteins: Targets and Tools for Chemosensitisation of Tumor Cells
Current Medicinal Chemistry - Anti-Cancer Agents Statins as Antihypertensives
Recent Patents on Cardiovascular Drug Discovery The Optimal Treatment of Severe Hypertension in Pregnancy: Update of the Role of Nicardipine
Current Pharmaceutical Biotechnology A Review of the Nephrotoxicity of the Food Flavor Cinnamaldehyde
Current Bioactive Compounds Carotid Baroreceptor Stimulation: A Promising Approach for the Management of Resistant Hypertension and Heart Failure
Current Vascular Pharmacology Chemical and Pharmacological Significance of 1,4-Dihydropyridines
Current Organic Chemistry Critical Questions for Preclinical Trials on Safety and Efficacy of Vascular Endothelial Growth Factor-Based Therapeutic Angiogenesis for Ischemic Stroke
CNS & Neurological Disorders - Drug Targets