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© 2007 American Society for Nutrition J. Nutr. 137:1687S-1692S, June 2007

Supplement: 6th Amino Acid Assessment Workshop: SESSION 3

Arginine in the Critical Care Setting1–3,

Minhao Zhou and Robert G. Martindale*

Department of Surgery, Oregon Health and Science University, Portland, OR 97239

* To whom correspondence should be addressed. E-mail: martindr{at}ohsu.edu.

Arginine is a nonessential amino acid in the normal physiological state that becomes conditionally essential during periods of hypermetabolic stress. Recent literature supports the hypothesis that arginine plays an important role in the intermediary metabolism of the critically ill patient. Current critical care literature is conflicting on arginine use in the clinical setting, with some proposing it as a panacea, whereas others report it as poison. Multiple individual reports and at least 5 major meta-analyses using combinations of immune-modulating nutrients have reported mostly beneficial results, but few have evaluated the effects of arginine when given as a single supplemental nutrient. This review attempts to objectively analyze the literature and evaluate the potential role of arginine in the critical care setting.




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