Effects of enteral feeding with eicosapentaenoic acid, γ-linolenic acid, and antioxidants in mechanically ventilated patients with severe sepsis and septic shock*
Abstract
OBJECTIVES: Enteral diets enriched with eicosapentaenoic acid (EPA), gamma-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 mortality in patients with severe sepsis or septic shock requiring mechanical ventilation. DESIGN: Prospective, double-blind, placebo-controlled, randomized trial. SETTING: Three different intensive care units of a tertiary hospital in Brazil. PATIENTS: The study enrolled 165 patients. INTERVENTIONS: Patients were randomized to be continuously tube-fed with either a diet enriched with EPA, GLA, and elevated antioxidants or an isonitrogenous and isocaloric control diet, delivered at a constant rate to achieve a minimum of 75% of basal energy expenditure x 1.3 during a minimum of 4 days. MEASUREMENTS AND MAIN RESULTS: Patients were monitored for 28 days. Patients who were fed with the study diet experienced a significant reduction in mortality rate compared with patients fed with the control diet, the absolute mortality reduction amounting to 19.4% (p = .037). The group who received the study diet also experienced significant improvements in oxygenation status, more ventilator-free days (13.4 +/- 1.2 vs. 5.8 +/- 1.0, p < .001), more intensive care unit (ICU)-free days (10.8 +/- 1.1 vs. 4.6 +/- 0.9, p < .001), and a lesser development of new organ dysfunctions (p < .001). CONCLUSIONS: In patients with severe sepsis or septic shock and requiring mechanical ventilation and tolerating enteral nutrition, a diet enriched with EPA, GLA, and elevated antioxidants contributed to better ICU and hospital outcomes and was associated with lower mortality rates.
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Pradelli et al. found a 4991 € cost reduction compared to PN-without GLN.
“They found a 4991 € cost reduction compared to PN-without GLN.”
From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [236]
The positive impact of parenteral GLN on cost has been clearly demonstrated.
“The positive impact of parenteral GLN on cost has been clearly demonstrated.”
From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [236]
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- Authors
- Pontes-Arruda, A., Aragão, A. M. A., & Albuquerque, J. D.
- Affiliations
- Latin American Sepsis Institute (BR)
- Venue
- Critical Care Medicine
- Published
- 2006-09
- Volume
- 34
- Issue
- 9
- Pages
- 2325-2333
- ISSN
- 0090-3493 (ISSN-L)
- OpenAlex
- W2076111774
- Cited by
- 423
- References
- 1
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 3 · 2023: 5 · 2022: 5 · 2021: 10 · 2020: 15 · 2019: 10 · 2018: 15 · 2017: 16 · 2016: 20 · 2015: 35 · 2014: 41 · 2013: 25 · 2012: 31
- FWCI
- 28.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
- Keywords
- enteral nutrition, eicosapentaenoic acid, gamma-linolenic acid, omega-3 fatty acids, antioxidants, vitamin supplementation, sepsis, septic shock, mechanical ventilation, 28-day mortality, ventilator-free days, ICU-free days, organ dysfunction, critically ill patients
- MeSH terms
- Aged, Antioxidants, Ascorbic Acid, Brazil, Double-Blind Method, Enteral Nutrition, Female, Humans, Intensive Care Units, Length of Stay, Male, Middle Aged, Multiple Organ Failure, Prospective Studies, Pulmonary Gas Exchange, Respiration, Artificial, Respiratory Distress Syndrome, Shock, Septic, Vitamin E, Eicosapentaenoic Acid, gamma-Linolenic Acid, Sepsis
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