Table 1.
Summary of expert recommendations on harm/benefit of specific ingredients in feeding formulas by population of critically ill patients [1,15,25]
| Patients | CCCPG | ESPEN | ASPEN/SCCM |
|---|---|---|---|
| General | Arginine (no benefit) No recommendation Antioxidants (possible benefit) |
No recommendation No recommendation No recommendation |
Antioxidants (possible benefit) Glutamine (possible benefit) Antioxidants (benefit) |
| Elective surgery | No recommendation | Arginine (benefit) | Arginine (benefit) |
| Trauma | Arginine (no benefit) Glutamine (possible benefit) No recommendation |
Arginine (benefit) Glutamine (benefit) No recommendation |
Arginine (benefit) Glutamine (possible benefit) Antioxidants (benefit) |
| Burns | Arginine (no benefit) Glutamine (possible benefit) No recommendation |
No recommendation Glutamine (benefit) Antioxidants (benefit) |
Arginine (benefit) Glutamine (possible benefit) Antioxidants (benefit) |
| Sepsis | Arginine (harm) No recommendation |
Arginine (harm if severe sepsis; benefit if mild) No recommendation |
Arginine (harm if severe sepsis; benefit if mild/moderate) Antioxidants (benefit) |
| ALI/ARDS | ω-3 fatty acids and ω-6 gamma-linolenic acid (benefit) Arginine (no benefit) No recommendation |
ω-3 fatty acids (benefit) No recommendation Antioxidants (benefit) |
ω-3 fatty acids and ω-6 gamma-linolenic acid (benefit) No recommendation Antioxidants (benefit) |
| Enteral feeding intolerance | Whole-protein formulas for most patients; hydrolyzed protein formula may be considered for patients with GI dysfunction such as short bowel syndrome, pancreatitis | Whole-protein formulas for most patients; hydrolyzed protein formula may be considered for GI dysfunction such as pancreatitis | Hydrolyzed protein formula may be considered for patients with GI dysfunction such as persistent diarrhea, pancreatitis |
ASPEN, American Society for Parenteral and Enteral Nutrition; CCCPG, Canadian Critical Care Practice Guidelines; ESPEN, European Society for Clinical Nutrition and Metabolism; GI, gastrointestinal; SCCM, Society of Critical Care Medicine.