Two previous studies showed that ARDS patients fed an enteral diet containing EPA+GLA and elevated antioxidants (Oxepa) had significantly increased oxygenation, and improved clinical outcomes. We investigated the potential benefits of the same diet in patients with ARDS in addition to Multiple Organ Dysfunction (MOD) which correlates strongly with the risk of intensive care unit (ICU) mortality.
We enrolled 16 ICU patients with ARDS (as defined by the American-European Consensus Conference) as a prospective, multicenter, double-blind, randomized controlled trial. Patients meeting entry criteria were randomized and continuously tube-fed EPA+GLA or an isonitrogenous, isocaloric standard diet at a minimum caloric delivery of 90% of basal energy expenditure for at least 4 days.
Ventilator settings were recorded and arterial blood gases were measured, at baseline and study days 4 and 7 to enable calculation of PaO2/FIO2, a marker for gas exchange and part of the Modified Lung Injury Score (LIS). Significant improvements in oxygenation (PaO2/FIO2) from baseline to study day 4 with lower ventilation variables (FIO2, positive end-expiratory pressure, and minute ventilation) occurred in patients with higher APACHE scoring at enrollment who were fed EPA+GLA compared with controls (p<.01). In addition, patients fed EPA+GLA had a decrease in their APACHE score 4 days after initiation of the enteral nutrition with decreased in length of stay in the intensive care unit (12.8 vs. 17.5 days; p = .016) compared with controls. Over all, patients fed EPA+GLA had a significant decrease in MOD score at 28 days after initiation of their tube feeding (p<.05).
This preliminary report support the previously reported benefits of EPA+GLA diet on gas exchange, and length of ICU stay. In addition, patients fed EPA+GLA had reduction of their APACHE score within 4days of initiating of the enteral nutrition with decreased MOD scores 28 days after initiation of their tube feeding.
Enteral nutrition of ARDS patients with EPA+GLA diet can improve their gas exchange, in addition to decrease length of ICU stay and 28 days mortality.
Elamin Elamin, None.