Immunonutrition and critical illness: an update

Nutrition. 2010 Jul-Aug;26(7-8):701-7. doi: 10.1016/j.nut.2009.11.010. Epub 2010 Apr 8.


Dietary supplementation with nutrients that have physiologic effects on immune function has been shown to be beneficial in subsets of patients with surgical and medical critical illness. However, several meta-analyses have suggested potential harm when immune nutrients are used inappropriately. This has led to concern among clinicians that in turn has curtailed the more widespread use of immunonutrition as a therapeutic modality. This article discusses the mechanisms by which immune nutrients can be used to modulate alterations in innate and acquired immunity associated with critical illness. In addition, recent evidence-based clinical practice guidelines for use of immunonutrition in adults is reviewed as a means to clarify some of the more controversial issues and provide a "roadmap" for the practitioner.

Publication types

  • Review

MeSH terms

  • Antioxidants / pharmacology
  • Antioxidants / therapeutic use
  • Arginine / pharmacology
  • Arginine / therapeutic use
  • Critical Illness*
  • Dietary Supplements
  • Fatty Acids / pharmacology
  • Fatty Acids / therapeutic use
  • Glutamine / pharmacology
  • Glutamine / therapeutic use
  • Guidelines as Topic
  • Humans
  • Immunity / drug effects*
  • Immunologic Factors / pharmacology
  • Immunologic Factors / therapeutic use*
  • Micronutrients / pharmacology
  • Micronutrients / therapeutic use*


  • Antioxidants
  • Fatty Acids
  • Immunologic Factors
  • Micronutrients
  • Glutamine
  • Arginine