Résumé
En plus d’apports adéquats de macronutriments, d’oligo-éléments et de vitamines, le patient agressé de réanimation pourrait bénéficier d’un apport complémentaire de nutriments particuliers. Le bénéfice hypothétique de cette stratégie repose soit sur la correction d’un déficit spécifique secondaire á une consommation accrue par l’agression, soit sur des effets de type pharmacologique, de modulation des fonctions physiologiques, en particulier immunitaire. Historiquement, le concept de nutrition immunomodulatrice, ou encore immune-enhancing diet des anglo-saxons, ou plus simplement immunonutrition, a précédé les autres approches. Actuellement, l’immunonutrition - terme attribué aux différentes solutions de nutrition artificielle qui mélangent différents composants et sont mises sur le marché sans faire l’objet d’une démonstration d’efficacité aussi exigeante que pour les médicaments — est progressivement remplacée par la « pharmaconutrition ». Cette dernière démarche plus rigoureuse sur le plan scientifique fait appel á l’étude des effets et á l’utilisation de nutriments individuels, se rapprochant ainsi de l’approche utilisée par l’industrie pharmaceutique (1). L’introduction de nouveaux termes, comme « alicaments » ou « nutraceutique » illustrent bien la tendance actuelle au rapprochement des techniques de validation de stratégies pharmaceutiques et nutritionnelles, bien au-delá de la réanimation.
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Preiser, JC., Malherbe, C. (2011). Pharmaconutriments et immunonutrition. In: Désordres métaboliques et réanimation. Le point sur .... Springer, Paris. https://doi.org/10.1007/978-2-287-99027-4_21
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DOI: https://doi.org/10.1007/978-2-287-99027-4_21
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