Purpose: We showed in a prospective, double-blinded multicenter study of ARDS patients that feeding a specialized enteral diet that contained EPA (fish oil), GLA (borage oil), and antioxidants (EPA+GLA) for 4 to 7 days significantly improved oxygenation and reduced ventilator and ICU days as compared with a control diet (Am J Resp Crit Care Med 1998;157(3):A677). To assess the potential mechanisms underlying these improved outcomes, we examined the role of pulmonary inflammation and incidence of new organ failures with this diet. Methods: Ninety-eight of 146 evaluable ARDS patients randomly received either EPA+GLA or an isocaloric control diet which was tube fed at a minimum of 75% of basal energy expenditure X 1.3 for 4 to 7 days. Bronchoalveolar lavage was performed at baseline, study day 4 and 7 to obtain lung fluid (BALF) for measuring total neutrophil counts and total protein. The percent of patients who developed a new organ failure during the study was recorded. Results: Demographic, physiologic, ventilatory and BALF parameters were similar between the groups at baseline. Analysis of BALF revealed a reduction in total neutrophil count (see figure) and total protein during the study with EPA+GLA as compared with the control diet. Only 8% of the patients fed EPA+GLA vs 28% of control patients developed a new organ failure during the study (p=0.015). Conclusions: Enteral nutrition with a specialized diet containing EPA, GLA and antioxidants significantly reduced pulmonary neutrophil recruitment and inflammation and lowered the incidence of new organ failures in ARDS patients. Clinical Implications: EPA+GLA would be a useful adjuvant therapy in the clinical management of pulmonary inflammation in patients with or at risk of ARDS. (Graph Presented).
|Published - Oct 1998
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine
- Cardiology and Cardiovascular Medicine