Benefit of an enteral diet enriched with eicosapentaenoic acid and gamma-linolenic acid in ventilated patients with acute lung injury.
OBJECTIVE
To explore the effects of an enteral diet enriched with eicosapentaenoic acid (EPA), gamma-linolenic acid (GLA), and antioxidants on the respiratory profile and outcome of patients with acute lung injury.


METHODS
Single-center, prospective, randomized, controlled, unblinded study.


METHODS
General intensive care department of a tertiary-care, university-affiliated hospital.


METHODS
A total of 100 patients with acute lung injury, diagnosed according to the American-European Consensus Conference on ARDS.


METHODS
Patients were randomized to receive the standard isonitrogenous, isocaloric enteral diet or the standard diet supplemented with EPA and GLA for 14 days.


RESULTS
Patient demographics, Acute Physiology and Chronic Health Evaluation II score, and type of admission were noted at admission. Compared with baseline oxygenation (EPA + GLA group vs. control group), by days 4 and 7, patients receiving the EPA + GLA diet showed significant improvement in oxygenation (PaO(2)/FIO(2), 317.3 +/- 99.5 vs. 214.3 +/- 56.4 and 296.5 +/- 165.3 vs. 236.3 +/- 79.8, respectively; p < .05). Compliance was significantly higher in the EPA + GLA group observed at day 7 (55.1 +/- 46.5 vs. 35.2 +/- 20.0 mL/mbar, p < .05). No significant difference was found in nutritional variables. Resting energy expenditure was significantly higher in patients in the EPA + GLA group, but their body mass index was also higher (p < .05). A significant difference was found in length of ventilation (p < .04) in favor of the EPA + GLA group. There was no between-group difference in survival.


CONCLUSIONS
In patients with acute lung injury, a diet enriched with EPA + GLA may be beneficial for gas exchange, respiratory dynamics, and requirements for mechanical ventilation.
Department of General Intensive Care, Rabin Medical Center, Petah Tiqva and Sackler Faculty of Medicine, Tel Aviv University, Israel.
Pierre
P
Singer
Myriam
M
Theilla
Haran
H
Fisher
Lilly
L
Gibstein
Elad
E
Grozovski
Jonathan
J
Cohen
D000328:Adult; D015118:Eicosapentaenoic Acid / Q000627:therapeutic use*; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D016896:Treatment Outcome; D017965:gamma-Linolenic Acid / Q000627:therapeutic use*
D017965:gamma-Linolenic Acid; D015118:Eicosapentaenoic Acid