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


CONCLUSIONS
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.
James 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.
Elamin M
EM
Elamin
Department 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.
Andrew C
AC
Miller
Department of Mathematics and Statistics, University of Maryland, Baltimore, Maryland, USA.
Sophia
S
Ziad
Acute respiratory distress syndrome (ARDS); Antioxidant; Eicosapentaenoic acid; Enteral nutrition; Gamma-linolenic acid; Multiple organ dysfunction