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J Nutr Disord Ther. 2012 Mar 26;2:109.

Immune Enteral Nutrition Can Improve Outcomes in Medical-Surgical Patients with ARDS: A Prospective Randomized Controlled Trial.

Author information

  • 1James A. Haley Veterans Hospital, Divisions of Pulmonary & Critical Care Medicine, 13000 Bruce B. Downs Blvd. (111C), Tampa, FL 33612, USA ; Department of Internal Medicine, and Divisions of Pulmonary & Critical Care Medicine, University of South Florida, Tampa, FL, USA.
  • 2Department of Critical Care Medicine, National Institutes of Health, Bethesda, MD, USA ; Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
  • 3Department of Mathematics and Statistics, University of Maryland, Baltimore, Maryland, USA.

Abstract

OBJECTIVE:

To determine if early continuous enteral feeding of a diet containing eicosapentaenoic acid (EPA), gamma-linolenic acid (GLA), docosahexaenoic acid, and antioxidants in surgical-medical patients with ARDS improves Lung Injury Score (LIS), gas exchange, Multiple Organ Dysfunction (MOD) Score, ICU length of stay, and days on mechanical ventilation.

METHODS:

Prospective randomized 2-center double-blind controlled trial of 17 ARDS patients whom continuously tube-fed the experimental diet (n=9) or an isonitrogenous, isocaloric standard diet (n=8) at a minimum caloric delivery of 90% of basal energy expenditure.

RESULTS:

In the experimental group, there was a decrease in lung injury score (p < 0.003) and lower ventilation variables (p < 0.001). Patients in the experimental group had a statistically significant decrease in 28-day MOD score (p < 0.05). The length of ICU stay was significantly decreased in the experimental group (12.8 vs. 17.5 days; p = 0.01). The study was underpowered to detect any survival benefits between the two groups.

CONCLUSION:

An EPA and GLA supplemented diet contributes to improved gas exchange in addition to decrease LIS, MOD scores and length of ICU stay in patients with ARDS. An EPA+GLA-enriched enteral diet may be an effective tool in the medical management of ARDS.

KEYWORDS:

Acute respiratory distress syndrome (ARDS); Antioxidant; Eicosapentaenoic acid; Enteral nutrition; Gamma-linolenic acid; Multiple organ dysfunction

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