The use of an inflammation-modulating diet in patients with acute lung injury or acute respiratory distress syndrome: a meta-analysis of outcome data.
BACKGROUND
This meta-analysis of clinical trials compares an inflammation-modulating diet enriched with eicosapentaenoic acid (EPA), gamma-linolenic acid (GLA), and elevated antioxidants (EPA + GLA) vs a control diet to determine the effectiveness of this specialized diet on oxygenation and clinical outcomes in mechanically ventilated patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS).


METHODS
MEDLINE, EMBASE, Cochrane Clinical Trials Register, and the U.S. National Institute of Health Clinical Trials databases were searched. The outcome measures assessed were 28-day in-hospital mortality, 28-day ventilator-free and intensive care unit (ICU)-free days, and the development of new organ failures. An evaluation of oxygenation and ventilatory variables was also performed. Outcomes were analyzed using both fixed-effects and random-effects models.


RESULTS
Three randomized controlled studies (n = 411 patients) were included in this meta-analysis. Among the most important findings of this evaluation is a significant reduction in the risk of mortality (odds ratio [OR] = 0.40; 95% confidence interval [CI] = 0.24-0.68; P = .001), with significant reductions in the risk of developing new organ failures (OR = 0.17; 95% CI = 0.08-0.34; P < .0001), time on mechanical ventilation (standardized mean difference [SMD] = 0.56; 95% CI = 0.32-0.79; P < .0001), and ICU stay (SMD = 0.51; 95% CI = 0.27-0.74; P < .0001) in patients who received EPA + GLA.


CONCLUSIONS
The meta-analysis showed a significant reduction in the risk of mortality as well as relevant improvements in oxygenation and clinical outcomes of ventilated patients with ALI/ARDS given EPA + GLA.
Pontes-Arruda
Alessandro
A
Intensive Care Department, Fernandes Távora Hospital, Fortaleza, Ceará, Brazil. pontes-arruda@secrel.com.br
Demichele
Stephen
S
Seth
Anand
A
Singer
Pierre
P
D055371:Acute Lung Injury / Q000150:complications / Q000401:mortality / Q000628:therapy*; D016001:Confidence Intervals; D004032:Diet; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D004750:Enteral Nutrition / Q000379:methods*; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D009102:Multiple Organ Failure / Q000453:epidemiology* / Q000209:etiology; D016017:Odds Ratio; D011659:Pulmonary Gas Exchange; D016032:Randomized Controlled Trials as Topic; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome; D017965:gamma-Linolenic Acid / Q000008:administration & dosage / Q000627:therapeutic use*
D017965:gamma-Linolenic Acid; D015118:Eicosapentaenoic Acid