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Benefit of an enteral diet enriched with eicosapentaenoic acid and gamma-linolenic acid in ventilated patients with acute lung injury*

Singer, Pierre MD; Theilla, Myriam RN; Fisher, Haran MD; Gibstein, Lilly MD; Grozovski, Elad MD; Cohen, Jonathan MD

doi: 10.1097/01.CCM.0000206111.23629.0A
Clinical Investigations

Objective: To explore the effects of an enteral diet enriched with eicosapentaenoic acid (EPA), gamma-linolenic acid (GLA), and antioxidants on the respiratory profile and outcome of patients with acute lung injury.

Design: Single-center, prospective, randomized, controlled, unblinded study.

Setting: General intensive care department of a tertiary-care, university-affiliated hospital.

Patients: A total of 100 patients with acute lung injury, diagnosed according to the American-European Consensus Conference on ARDS.

Interventions: Patients were randomized to receive the standard isonitrogenous, isocaloric enteral diet or the standard diet supplemented with EPA and GLA for 14 days.

Measurements and Main Results: Patient demographics, Acute Physiology and Chronic Health Evaluation II score, and type of admission were noted at admission. Compared with baseline oxygenation (EPA + GLA group vs. control group), by days 4 and 7, patients receiving the EPA + GLA diet showed significant improvement in oxygenation (Pao2/Fio2, 317.3 ± 99.5 vs. 214.3 ± 56.4 and 296.5 ± 165.3 vs. 236.3 ± 79.8, respectively; p < .05). Compliance was significantly higher in the EPA + GLA group observed at day 7 (55.1 ± 46.5 vs. 35.2 ± 20.0 mL/mbar, p < .05). No significant difference was found in nutritional variables. Resting energy expenditure was significantly higher in patients in the EPA + GLA group, but their body mass index was also higher (p < .05). A significant difference was found in length of ventilation (p < .04) in favor of the EPA + GLA group. There was no between-group difference in survival.

Conclusions: In patients with acute lung injury, a diet enriched with EPA + GLA may be beneficial for gas exchange, respiratory dynamics, and requirements for mechanical ventilation.

From the Department of General Intensive Care, Rabin Medical Center, Beilinson Campus, Petah Tiqva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Supported, in part by Ross Laboratories, Chicago, IL, which provided the enteral formulas.

© 2006 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins