Which nutritional components have demonstrated improved outcomes in patients with acute respiratory distress syndrome (ARDS)?

Updated: Mar 27, 2020
  • Author: Eloise M Harman, MD; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

A number of different combinations of nutritional components have been investigated with mixed results. A low-carbohydrate high-fat enteral formula including anti-inflammatory and vasodilating components (eicosapentaenoic acid and linoleic acid) along with antioxidants has been demonstrated in some studies to improve outcome in ARDS. [54, 55] In a prospective, randomized study of ARDS patients in Brazil given an enteral formula containing antioxidants, eicosapentaenoic acid, and gamma-linoleic acid compared with a standard isocaloric formula, Pontes-Arruda et al demonstrated improved survival and oxygenation with the specialized diet. [55] However, in 2011, a randomized controlled trial compared enteral supplementation with omega-3 fatty acids, gamma-linolenic acid, and antioxidants to an isocaloric control in 272 patients diagnosed with acute lung injury. [56] The study was stopped early for futility since the n-3 group had a 60-day mortality rate of 26.6% and the control group had a 16.3% 60-day mortality rate.


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