par Fraipont, Vincent;Preiser, Jean-Charles 
Référence Nutrition clinique et métabolisme, 31, 1, page (16-23)
Publication Publié, 2017-02
Référence Nutrition clinique et métabolisme, 31, 1, page (16-23)
Publication Publié, 2017-02
Article révisé par les pairs
| Résumé : | The second part of this review dedicated to pharmaconutrition of the critically ill summarizes the currently available data on antioxidants and Ω-3 fatty acids. In both cases, the rationale lies on the modulation of the host response to injury. Regarding the antioxidants, the goal of the supplementation is to restore or to enhance the endogenous defense mechanisms by adding vitamins or trace elements serving as co-enzymes of antioxidant systems, as the endogenous stores have been exhausted by the stress. The clinical trials assessed selenium-based compounds and/or vitamins A, C and E. Overall, the expected benefit of these interventions has not been confirmed except when given during continuous renal replacement therapy. Regarding the Ω-3 fatty acids, the benefit of enteral supplementation during acute respiratory distress syndrome has not been confirmed. Some benefit could be afforded by parenteral solutions enriched with Ω-3 fatty acids. In both cases, as for any medication, the risk-to-benefit ratio of these nutritional interventions should be thoroughly assessed in defined categories of patients or situations deemed at high risk. |
