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The Use of an Inflammation‐Modulating Diet in Patients With Acute Lung Injury or Acute Respiratory Distress Syndrome: A Meta‐Analysis of Outcome Data
Author(s) -
PontesArruda Alessandro,
DeMichele Stephen,
Seth Anand,
Singer Pierre
Publication year - 2008
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607108324203
Subject(s) - medicine , ards , meta analysis , odds ratio , mechanical ventilation , confidence interval , randomized controlled trial , clinical trial , intensive care unit , relative risk , eicosapentaenoic acid , lung , polyunsaturated fatty acid , fatty acid , chemistry , organic chemistry
Background : This meta‐analysis of clinical trials compares an inflammation‐modulating diet enriched with eicosapentaenoic acid (EPA),γ ‐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.