Effects of enteral feeding with eicosapentaenoic acid, γ-linolenic acid, and antioxidants in mechanically ventilated patients with severe sepsis and septic shock*

@article{PontesArruda2006EffectsOE,
  title={Effects of enteral feeding with eicosapentaenoic acid, $\gamma$-linolenic acid, and antioxidants in mechanically ventilated patients with severe sepsis and septic shock*},
  author={Alessandro Pontes-Arruda and Afra Maria Albuquerque Arag{\~a}o and Juliana Deusdar{\'a} Albuquerque},
  journal={Critical Care Medicine},
  year={2006},
  volume={34},
  pages={2325-2333}
}
Objectives:Enteral diets enriched with eicosapentaenoic acid (EPA), γ-linolenic acid (GLA), and antioxidants have previously been shown to improve outcomes in patients with acute respiratory distress syndrome. Several studies using animal models of sepsis demonstrate that enteral nutrition enriched with omega-3 fatty acids reduces mortality rate. This study investigated whether an enteral diet enriched with EPA, GLA, and antioxidant vitamins can improve outcomes and reduce 28-day all-cause… 

Effect of enteral diet enriched with eicosapentaenoic acid, gamma-linolenic acid, and antioxidants in patients with sepsis-induced acute respiratory distress syndrome

An enteral diet enriched with EPA, GLA, and antioxidants did not improve duration of mechanical ventilation, SOFA score, incidence of new nosocomial infections, or mortality but did favorably influence duration of ICU stay in critically ill patients with sepsis-induced ARDS.

Enteral nutrition with eicosapentaenoic acid, γ-linolenic acid and antioxidants in the early treatment of sepsis: results from a multicenter, prospective, randomized, double-blinded, controlled study: the INTERSEPT Study

The data suggest that EPA/GLA may play a beneficial role in the treatment of enterally fed patients in the early stages of sepsis, without associated progression of septic shock, and intention-to-treat analysis demonstrated that patients fed the EPA/ GLA diet developed less severe sepsi and/or septicshock.

Preemptive enteral nutrition enriched with eicosapentaenoic acid, gamma-linolenic acid and antioxidants in severe multiple trauma: a prospective, randomized, double-blind study

This study failed to show a significant benefit for the preemptive use of the study formula in patients with severe trauma, and the Omega-3 Index (O-3I) failed to reach those suggested as being optimal to obtain clinical efficacy.

The effects of enteral feeding with eicosapentaenoic acid, γ-linolenic acid and antioxidant vitamins on mechanically ventilated patients with severe sepsis and septic shock: a retrospective analysis of Japanese-descendant patients

In Japanese-descendant patients with severe sepsis or septic shock and requiring mechanical ventilation and tolerating enteral nutrition, a diet enriched with EPA, GLA and antioxidants contributed to better ICU outcomes.

Enteral omega-3 fatty acid, gamma-linolenic acid, and antioxidant supplementation in acute lung injury.

Twice-daily enteral supplementation of n-3 fatty acids, γ-linolenic acid, and antioxidants did not improve the primary end point of ventilator-free days or other clinical outcomes in patients with acute lung injury and may be harmful.

Comments on Kagan et al.: Preemptive enteral nutrition enriched with eicosapentaenoic acid, gamma-linolenic acid and antioxidants in severe multiple trauma: a prospective, randomized, double-blind study

Over the time course of the trial no clinically significant x-3 PUFA indexes were reached which would be expected to exert any beneficial effects, and the trial demonstrates once more that absence of evidence is not evidence of absence.

Impact of two pulmonary enteral formulations on nutritional indices and outcomes.

The use of a specialised pulmonary enteral formulation did not result in any statistically significant effects on ICU days and hours on mechanical ventilation, and subjects who were on the specialised formula did receive more enteral formula volume and more total energy intake, which may be clinically important.

Enteral Immunomodulatory Diet (Omega-3 Fatty Acid, γ-Linolenic Acid and Antioxidant Supplementation) for Acute Lung Injury and Acute Respiratory Distress Syndrome: An Updated Systematic Review and Meta-Analysis

The enteral immunomodulatory diet could not reduce the severity of the patients with ALi/ARDS, and for ALI/ARDS patients with high mortality, this treatment might reduce the all-cause mortality, but its use should be treated with discretion.

Immune Enteral Nutrition Can Improve Outcomes in Medical-Surgical Patients with ARDS: A Prospective Randomized Controlled Trial

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, and may be an effective tool in the medical management of ARDS.
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References

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Effect of enteral feeding with eicosapentaenoic acid, gamma-linolenic acid, and antioxidants in patients with acute respiratory distress syndrome. Enteral Nutrition in ARDS Study Group.

The beneficial effects of the EPA+GLA diet on pulmonary neutrophil recruitment, gas exchange, requirement for mechanical ventilation, length of intensive care unit stay, and the reduction of new organ failures suggest that this enteral nutrition formula would be a useful adjuvant therapy in the clinical management of patients with or at risk of developing ARDS.

Enteral nutrition with eicosapentaenoic acid, &ggr;-linolenic acid, and antioxidants reduces alveolar inflammatory mediators and protein influx in patients with acute respiratory distress syndrome

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The polyunsaturated fatty acid composition of AM phi, lung, and KE cell phospholipids can be rapidly modified by continuous short-term enteral feeding with EPA- and GLA-enriched diets irrespective of concurrent endotoxemia.
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