title: Effect of an enteral diet enriched with eicosapentaenoic acid, gamma-linolenic acid and anti-oxidants on the outcome of mechanically ventilated, critically ill, septic patients.
abstract: OBJECTIVE
  To assess the effect of an enteral diet enriched with eicosapentaenoic acid (EPA), gamma-linolenic acid (GLA), and anti-oxidants on the incidence of organ dysfunction and nosocomial infections in septic patients with acute lung injury or acute respiratory distress syndrome (ARDS) compared with a standard enteral diet.
  
  
  METHODS
  This prospective, randomized, open-label study was performed in 11 Spanish intensive care units (ICU). Adult patients with sepsis and acute lung injury or ARDS were randomly allocated to receive either an EPA-GLA diet or a control diet.
  
  
  RESULTS
  Of the 198 patients that were eligible, 160 were randomized and 132 were studied. Patient demographics, APACHE II and SOFA scores, and nutritional variables on admission were similar between the EPA-GLA diet and control diet groups. The EPA-GLA diet group showed a trend toward a decreased SOFA score, but it was not significant. No differences were observed in the PaO(2)/FiO(2) ratio or the days on mechanical ventilation between the groups. Incidence of infections was similar in the groups. The control group stayed longer in the ICU than the EPA-GLA diet group (16 vs. 18; p = 0.02).
  
  
  CONCLUSIONS
  A diet enriched with EPA, GLA, and anti-oxidants does not improve gas exchange or decrease the incidence of novel organ failures in critically ill septic patients with acute lung injury or ARDS. Patients treated with the EPA-GLA diet stayed in the ICU for less time, but we did not find any differences in infectious complications.
authors.affiliation: Hospital Universitario Doce de Octubre, Avenida de Córdoba s/n., Madrid E-28041, Spain. teograu2@terra.es
authors.forename: Teodoro
authors.initials: T
authors.lastname: Grau-Carmona
authors.forename: Vicente
authors.initials: V
authors.lastname: Morán-García
authors.forename: Abelardo
authors.initials: A
authors.lastname: García-de-Lorenzo
authors.forename: Gabriel
authors.initials: G
authors.lastname: Heras-de-la-Calle
authors.forename: Belén
authors.initials: B
authors.lastname: Quesada-Bellver
authors.forename: Jorge
authors.initials: J
authors.lastname: López-Martínez
authors.forename: Camilo
authors.initials: C
authors.lastname: González-Fernández
authors.forename: Juan C
authors.initials: JC
authors.lastname: Montejo-González
authors.forename: Antonio
authors.initials: A
authors.lastname: Blesa-Malpica
authors.forename: Immaculada
authors.initials: I
authors.lastname: Albert-Bonamusa
authors.forename: Alfonso
authors.initials: A
authors.lastname: Bonet-Saris
authors.forename: José I
authors.initials: JI
authors.lastname: Herrero-Meseguer
authors.forename: Alfonso
authors.initials: A
authors.lastname: Mesejo
authors.forename: Jose
authors.initials: J
authors.lastname: Acosta
mesh_terms: D055371:Acute Lung Injury / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000627:therapeutic use; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control; D015118:Eicosapentaenoic Acid / Q000627:therapeutic use*; D004750:Enteral Nutrition; D005260:Female; D005526:Food, Formulated / Q000032:analysis; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D057194:Intention to Treat Analysis; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D018805:Sepsis / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D013030:Spain / Q000453:epidemiology; D017965:gamma-Linolenic Acid / Q000627:therapeutic use*
chemical_list: D000975:Antioxidants; D017965:gamma-Linolenic Acid; D015118:Eicosapentaenoic Acid