Benefit of an enteral diet enriched with eicosapentaenoic acid and gamma-linolenic acid in ventilated patients with acute lung injury
Benefit of an enteral diet enriched with eicosapentaenoic acid and gamma-linolenic acid in ventilated patients with acute lung injury
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DOI：
10.1097/01.ccm.0000206111.23629.0a
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发表时间：
2006-04-01
影响因子：
8.8
通讯作者：
Cohen, J
中科院分区：
文献类型：
--
作者：
Singer, P;Theilla, M;Cohen, J
目的：探讨富含二十碳五烯酸（EPA）、γ -亚麻酸（GLA）和抗氧化剂的肠内饮食对急性肺损伤患者呼吸功能和预后的影响。单中心、前瞻性、随机、对照、非盲法研究。地点：大学附属三级医院普通重症监护室。患者：根据欧美ARDS共识会议诊断的急性肺损伤患者共100例。干预措施：患者随机接受标准等氮、等热量肠内饮食或添加EPA和GLA的标准饮食，为期14天。测量和主要结果。入院时记录患者人口统计学、急性生理和慢性健康评估II评分以及入院类型。与基线氧合（EPA + GLA组与对照组）相比，在第4天和第7天，接受EPA + GLA饮食的患者氧合水平显著改善(Pao(2)/FIO2分别为317.3 +/- 99.5 vs. 214.3 +/- 56.4和296.5 +/- 165.3 vs. 236.3 +/- 79.8；P < 0.05)。在第7天观察到的EPA + GLA组的依从性明显更高（55.1 +/- 46.5 vs. 35.2 +/- 20.0 mL/mbar, p < 0.05）。营养指标无显著差异。EPA + GLA组患者的静息能量消耗显著增加，但其体重指数也较高（p < 0.05）。EPA + GLA组通气时间差异有统计学意义（p < 0.04）。组间生存率无差异。结论：在急性肺损伤患者中，富含EPA + GLA的饮食可能有利于气体交换、呼吸动力学和机械通气需求。
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 (Pao(2)/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.