title: Impact of two pulmonary enteral formulations on nutritional indices and outcomes.
abstract: BACKGROUND
  Enteral nutrition formulas enriched with eicosapentaenoic acid (EPA) and gamma-linolenic acid (GLA) may modulate inflammatory processes and improve outcomes in mechanically-ventilated patients with respiratory failure. The present study aimed to determine whether there were differences in nutritional indices (protein intake, energy intake, fat intake) and outcomes [days on mechanical ventilation, days in the intensive care unit (ICU)] between mechanically-ventilated subjects who received a standard pulmonary enteral formula compared to those who received an EPA/GLA enriched pulmonary enteral formula.
  
  
  METHODS
  Data on 50 adult subjects who were admitted to an ICU in a community hospital who required both mechanical ventilation and enteral nutrition support were collected (n = 19 in the standard enteral formula group; n = 31 in the EPA/GLA-enriched enteral formula group). The present study involved both retrospective and prospective data.
  
  
  RESULTS
  Subjects who were provided the EPA/GLA enriched enteral formula received significantly more enteral formula volume (P = 0.011), total fat (P < 0.0005) and total energy (P = 0.017) than subjects who were provided the standard enteral formula. When controlling for the effects of enteral formula volume, total fat intake and total energy intake as confounding variables, there were no significant differences between the enteral formula groups in ICU days (P = 0.440) or hours spent on mechanical ventilation (P = 0.410).
  
  
  CONCLUSIONS
  The use of a specialised pulmonary enteral formulation did not result in any statistically significant effects on ICU days and hours on mechanical ventilation. Subjects who were on the specialised formula did receive more enteral formula volume and more total energy intake, which may be clinically important. Further clinical studies are needed to address the impact that a specialised pulmonary enteral formula has on ICU stay and ventilator hours.
authors.affiliation: Department of Individual, Family, and Community Education, Nutrition Program, College of Education, University of New Mexico, Albuquerque, NM, USA. dcohen02@unm.edu
authors.forename: D A
authors.initials: DA
authors.lastname: Cohen
authors.forename: L
authors.initials: L
authors.lastname: Byham-Gray
authors.forename: R M
authors.initials: RM
authors.lastname: Denmark
mesh_terms: D000368:Aged; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage; D002149:Energy Intake; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods; D012131:Respiratory Insufficiency / Q000503:physiopathology / Q000628:therapy; D012189:Retrospective Studies; D017965:gamma-Linolenic Acid / Q000008:administration & dosage
chemical_list: D004041:Dietary Fats; D004044:Dietary Proteins; D017965:gamma-Linolenic Acid; D015118:Eicosapentaenoic Acid