Enteral nutrition with eicosapentaenoic acid (EPA), γ-linolenic acid (GLA) and antioxidants reduces pulmonary inflammation and new organ failures in patients with Acute Respiratory Distress Syndrome (ARDS)

James E. Gadek, S. DeMichele, M. Karlstad, M. Murray, E. Pacht, M. Donahoe, T. Albertson, C. Van Hoozen, A. Wennberg, J. Nelson, M. Noursalehi

Research output: Contribution to journalArticle

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Abstract

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).

Original languageEnglish (US)
JournalChest
Volume114
Issue number4 SUPPL.
StatePublished - Oct 1998
Externally publishedYes

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alpha-Linolenic Acid
Eicosapentaenoic Acid
Adult Respiratory Distress Syndrome
Enteral Nutrition
Pneumonia
Antioxidants
Diet
Neutrophils
Lung
Neutrophil Infiltration
Fish Oils
Incidence
Bronchoalveolar Lavage
Mechanical Ventilators
Energy Metabolism
Multicenter Studies
Small Intestine
Proteins
Demography
Inflammation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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Enteral nutrition with eicosapentaenoic acid (EPA), γ-linolenic acid (GLA) and antioxidants reduces pulmonary inflammation and new organ failures in patients with Acute Respiratory Distress Syndrome (ARDS). / Gadek, James E.; DeMichele, S.; Karlstad, M.; Murray, M.; Pacht, E.; Donahoe, M.; Albertson, T.; Van Hoozen, C.; Wennberg, A.; Nelson, J.; Noursalehi, M.

In: Chest, Vol. 114, No. 4 SUPPL., 10.1998.

Research output: Contribution to journalArticle

Gadek, JE, DeMichele, S, Karlstad, M, Murray, M, Pacht, E, Donahoe, M, Albertson, T, Van Hoozen, C, Wennberg, A, Nelson, J & Noursalehi, M 1998, 'Enteral nutrition with eicosapentaenoic acid (EPA), γ-linolenic acid (GLA) and antioxidants reduces pulmonary inflammation and new organ failures in patients with Acute Respiratory Distress Syndrome (ARDS)', Chest, vol. 114, no. 4 SUPPL..
Gadek, James E. ; DeMichele, S. ; Karlstad, M. ; Murray, M. ; Pacht, E. ; Donahoe, M. ; Albertson, T. ; Van Hoozen, C. ; Wennberg, A. ; Nelson, J. ; Noursalehi, M. / Enteral nutrition with eicosapentaenoic acid (EPA), γ-linolenic acid (GLA) and antioxidants reduces pulmonary inflammation and new organ failures in patients with Acute Respiratory Distress Syndrome (ARDS). In: Chest. 1998 ; Vol. 114, No. 4 SUPPL.
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title = "Enteral nutrition with eicosapentaenoic acid (EPA), γ-linolenic acid (GLA) and antioxidants reduces pulmonary inflammation and new organ failures in patients with Acute Respiratory Distress Syndrome (ARDS)",
abstract = "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).",
author = "Gadek, {James E.} and S. DeMichele and M. Karlstad and M. Murray and E. Pacht and M. Donahoe and T. Albertson and {Van Hoozen}, C. and A. Wennberg and J. Nelson and M. Noursalehi",
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T1 - Enteral nutrition with eicosapentaenoic acid (EPA), γ-linolenic acid (GLA) and antioxidants reduces pulmonary inflammation and new organ failures in patients with Acute Respiratory Distress Syndrome (ARDS)

AU - Gadek, James E.

AU - DeMichele, S.

AU - Karlstad, M.

AU - Murray, M.

AU - Pacht, E.

AU - Donahoe, M.

AU - Albertson, T.

AU - Van Hoozen, C.

AU - Wennberg, A.

AU - Nelson, J.

AU - Noursalehi, M.

PY - 1998/10

Y1 - 1998/10

N2 - 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).

AB - 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).

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JO - Chest

JF - Chest

SN - 0012-3692

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