Immune Enteral Nutrition Can Improve Outcomes in Medical-Surgical Patients with ARDS: A Prospective Randomized Controlled Trial
Elamin M Elamin1,2*, Andrew C Miller3,4 and Sophia Ziad5
1James A. Haley Veterans Hospital, Divisions of Pulmonary & Critical Care Medicine, 13000 Bruce B. Downs Blvd. (111C), Tampa, FL 33612, USA
2Department of Internal Medicine, and Divisions of Pulmonary & Critical Care Medicine, University of South Florida, Tampa, FL, USA
3Department of Critical Care Medicine, National Institutes of Health, Bethesda, MD, USA
4Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
5Department of Mathematics and Statistics, University of Maryland, Baltimore, Maryland, USA
- *Corresponding Author:
- Elamin M Elamin, MD, MSc, FACP, FCCP
Professor of Medicine, Assistant Chief
Pulmonary, Critical Care & Sleep Medicine Section
James A. Haley Veterans Hospital
13000 Bruce B. Downs Blvd. (111C)
Tampa, FL 33612, USA
E-mail: [email protected]
Received Date: March 05, 2012; Accepted Date: March 23, 2012; Published Date: March 26, 2012
Citation: Elamin EM, Miller AC, Ziad S (2012) Immune Enteral Nutrition Can Improve Outcomes in Medical-Surgical Patients with ARDS: A Prospective Randomized Controlled Trial. J Nutr Disorders Ther 2:109. doi: 10.4172/2161-0509.1000109
Copyright: © 2012 Elamin EM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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.
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.
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.