title: Enteral Immunomodulatory Diet (Omega-3 Fatty Acid, γ-Linolenic Acid and Antioxidant Supplementation) for Acute Lung Injury and Acute Respiratory Distress Syndrome: An Updated Systematic Review and Meta-Analysis.
abstract: Enteral immunomodulatory nutrition is considered as a promising therapy for the treatment of acute lung injury and acute respiratory distress syndrome (ALI/ARDS). However, there are still some divergences, and it is unclear whether this treatment should be recommended for patients with ALI/ARDS. Therefore, we conducted this systematic review and meta-analysis to assess the efficacy and safety of an enteral immunomodulatory diet on the clinical outcomes of ALI/ARDS patients.
  
  
  METHODS
  We retrieved potentially relevant clinical trials though electronic databases. All trials of enteral immunomodulatory diet for ALI/ARDS were included. Analyses of the overall all-cause mortality, 28-day ventilator-free days and 28-day intensive care unit (ICU) free days were conducted.
  
  
  RESULTS
  In total six controlled trials were evaluated. The pooled results did not show a significant reduction in the risk of all-cause mortality (M-H RR (the overall Mantel-Haenszel relative risk), 0.81 (95% CI, 0.50-1.31); p = 0.38; 6 trials, n = 717) in ALI/ARDS patients treated with the immunomodulatory diet. This treatment also did not extend the ventilator-free days and ICU-free days. However, patients with high mortality might benefit from this treatment.
  
  
  CONCLUSIONS
  The enteral immunomodulatory diet could not reduce the severity of the patients with ALI/ARDS. Whereas, for ALI/ARDS patients with high mortality, this treatment might reduce the all-cause mortality, but its use should be treated with discretion.
authors.affiliation: These authors contributed equally to this paper.. licong1988@hotmail.com.
authors.forename: Congcong
authors.initials: C
authors.lastname: Li
authors.affiliation: These authors contributed equally to this paper.. boliyan@hotmail.com.
authors.forename: Liyan
authors.initials: L
authors.lastname: Bo
authors.affiliation: These authors contributed equally to this paper.. liuweilung@163.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.affiliation: These authors contributed equally to this paper.. luxi1126@163.com.
authors.forename: Xi
authors.initials: X
authors.lastname: Lu
authors.affiliation: These authors contributed equally to this paper.. jinfag@fmmu.edu.cn.
authors.forename: Faguang
authors.initials: F
authors.lastname: Jin
mesh_terms: D055371:Acute Lung Injury / Q000178:diet therapy*; D000975:Antioxidants / Q000008:administration & dosage / Q000494:pharmacology*; D004041:Dietary Fats / Q000008:administration & dosage / Q000494:pharmacology*; D004750:Enteral Nutrition; D006801:Humans; D012128:Respiratory Distress Syndrome / Q000178:diet therapy*; D017965:gamma-Linolenic Acid / Q000008:administration & dosage / Q000494:pharmacology*
chemical_list: D000975:Antioxidants; D004041:Dietary Fats; D017965:gamma-Linolenic Acid
keywords: acute lung injury; acute respiratory distress syndrome; critical care; enteral nutrition; immunomodulatory diet; mortality