title: Parenteral or Enteral Arginine Supplementation Safety and Efficacy.
abstract: Arginine supplementation has the potential to improve the health of patients. Its use in hospitalized patients has been a controversial topic in the nutrition literature, especially concerning supplementation of septic patients. In this article, we review the relevant literature both for and against the use of arginine in critically ill, surgical, and hospitalized patients. The effect of critical illness on arginine metabolism is reviewed, as is its use in septic and critically ill patients. Although mounting evidence supports immunonutrition, there are only a few studies that suggest that this is safe in patients with severe sepsis. The use of arginine has been shown to benefit a variety of critically ill patients. It should be considered for inclusion in combinations of immunonutrients or commercial formulations for groups in whom its benefit has been reported consistently, such as those who have suffered trauma and those in acute surgical settings. The aims of this review are to discuss the role of arginine in health, the controversy surrounding arginine supplementation of septic patients, and the use of arginine in critically ill patients.
authors.affiliation: Division of Acute Care Surgery, Department of Surgery, and.|Center for Sepsis and Critical Illness Research, University of Florida College of Medicine, Gainesville, FL.
authors.forename: Martin D
authors.initials: MD
authors.lastname: Rosenthal
authors.affiliation: Section of Cardiothoracic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI.
authors.forename: Phillip W
authors.initials: PW
authors.lastname: Carrott
authors.affiliation: Division of Pulmonary Critical Care, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI; and.
authors.forename: Jayshil
authors.initials: J
authors.lastname: Patel
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Oregon Health and Science University, Portland, OR.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Kiraly
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Oregon Health and Science University, Portland, OR martindr@ohsu.edu.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Martindale
mesh_terms: D001120:Arginine / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology*; D016638:Critical Illness; D019587:Dietary Supplements; D004750:Enteral Nutrition; D006801:Humans; D007263:Infusions, Parenteral
chemical_list: D001120:Arginine
keywords: arginine supplementation; critical care; immunonutrition; sepsis; surgery