The Role of Nutritional Support in Sepsis

Abstract

The critically ill patient with sepsis experiences a unique pathophysiologic state that promotes deterioration of organ function and systemic immunity. Beyond its effect on nutritional status, providing nutritional support by the enteral route may modify the course of sepsis through maintenance of gut structure and function, thereby reducing the inflammatory response to sepsis, and improving clinical outcomes. Parenteral nutrition seems to have little role and may even worsen outcomes in sepsis. While use of immune-enhancing nutrients may be helpful in a variety of patient groups who are non-septic, evidence for possible deleterious effects may prevent their use in patients who have pre-existing infection. Careful selection and close monitoring should maximize efficacy and benefit from the nutritional support regimen in this complex patient population.