The use of an inflammation-modulating diet in patients with acute lung injury or acute respiratory distress syndrome: a meta-analysis of outcome data

JPEN J Parenter Enteral Nutr. Nov-Dec 2008;32(6):596-605. doi: 10.1177/0148607108324203.

Abstract

Background: This meta-analysis of clinical trials compares an inflammation-modulating diet enriched with eicosapentaenoic acid (EPA), gamma-linolenic acid (GLA), and elevated antioxidants (EPA + GLA) vs a control diet to determine the effectiveness of this specialized diet on oxygenation and clinical outcomes in mechanically ventilated patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS).

Methods: MEDLINE, EMBASE, Cochrane Clinical Trials Register, and the U.S. National Institute of Health Clinical Trials databases were searched. The outcome measures assessed were 28-day in-hospital mortality, 28-day ventilator-free and intensive care unit (ICU)-free days, and the development of new organ failures. An evaluation of oxygenation and ventilatory variables was also performed. Outcomes were analyzed using both fixed-effects and random-effects models.

Results: Three randomized controlled studies (n = 411 patients) were included in this meta-analysis. Among the most important findings of this evaluation is a significant reduction in the risk of mortality (odds ratio [OR] = 0.40; 95% confidence interval [CI] = 0.24-0.68; P = .001), with significant reductions in the risk of developing new organ failures (OR = 0.17; 95% CI = 0.08-0.34; P < .0001), time on mechanical ventilation (standardized mean difference [SMD] = 0.56; 95% CI = 0.32-0.79; P < .0001), and ICU stay (SMD = 0.51; 95% CI = 0.27-0.74; P < .0001) in patients who received EPA + GLA.

Conclusions: The meta-analysis showed a significant reduction in the risk of mortality as well as relevant improvements in oxygenation and clinical outcomes of ventilated patients with ALI/ARDS given EPA + GLA.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Lung Injury / complications
  • Acute Lung Injury / mortality
  • Acute Lung Injury / therapy*
  • Confidence Intervals
  • Diet
  • Eicosapentaenoic Acid / administration & dosage
  • Eicosapentaenoic Acid / therapeutic use*
  • Enteral Nutrition / methods*
  • Hospital Mortality*
  • Humans
  • Length of Stay
  • Multiple Organ Failure / epidemiology*
  • Multiple Organ Failure / etiology
  • Odds Ratio
  • Pulmonary Gas Exchange
  • Randomized Controlled Trials as Topic
  • Respiration, Artificial
  • Respiratory Distress Syndrome / complications
  • Respiratory Distress Syndrome / mortality
  • Respiratory Distress Syndrome / therapy*
  • Treatment Outcome
  • gamma-Linolenic Acid / administration & dosage
  • gamma-Linolenic Acid / therapeutic use*

Substances

  • gamma-Linolenic Acid
  • Eicosapentaenoic Acid