Utilização de imunonutrientes em pacientes críticos sépticos: uma revisão de evidências científicas

Objective: To review the scientific evidence on the use of immunonutrients in septic patients. Data source: The bibliographic searches were conducted in Pubmed, Scielo, Bireme and Scopus with time frame of the past five years in English, Portuguese and Spanish. Data synthesis: After the analysis of the studies, neither enteral or parenteral glutamine should be used in critically ill patients, except for burn patients. Regarding arginine there is no prospective, randomized controlled published trial using arginine as a single agent in sepsis the past five years. In the case of Omega 3, most studies have evaluated its effect associated with antioxidants, so it is not possible to establish a specific indication of the nutrient. The same is true with supplementation of vitamins associated with selenium. Conclusions: There was no consensus on the immunonutrients recommendation among the analyzed articles. Further studies are needed to define dose, route of administration and the ideal time for the administration of each immunomodulator in subgroups of septic critically ill patients.