Abstract

Arginine is a conditional amino acid that has a wide breadth of metabolic activity and applications when supplemented. During critical illness, high stressed states, and increased metabolic demand arginine becomes an essential amino acid. It is during this time that supplementation benefits the host. Arginine supplementation during sepsis, however, has remained controversial as there is theoretical harm stemming from arginine serving as a substrate for nitric oxide production. In this review we discuss the literature both in support of and against the use of arginine in all critically ill patients, as well as, advocate for ongoing research to better understand appropriate dosage of arginine in relation to the arginine: asymmetric dimethylarginine ratio.

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