Department of Individual, Family, and Community Education, Nutrition Program, College of Education, University of New Mexico, Albuquerque, NM, USA.
J Hum Nutr Diet. 2013 Jun;26(3):286-93. doi: 10.1111/j.1365-277X.2012.01292.x. Epub 2012 Nov 29.
Enteral nutrition formulas enriched with eicosapentaenoic acid (EPA) and gamma-linolenic acid (GLA) may modulate inflammatory processes and improve outcomes in mechanically-ventilated patients with respiratory failure. The present study aimed to determine whether there were differences in nutritional indices (protein intake, energy intake, fat intake) and outcomes [days on mechanical ventilation, days in the intensive care unit (ICU)] between mechanically-ventilated subjects who received a standard pulmonary enteral formula compared to those who received an EPA/GLA enriched pulmonary enteral formula.
Data on 50 adult subjects who were admitted to an ICU in a community hospital who required both mechanical ventilation and enteral nutrition support were collected (n = 19 in the standard enteral formula group; n = 31 in the EPA/GLA-enriched enteral formula group). The present study involved both retrospective and prospective data.
Subjects who were provided the EPA/GLA enriched enteral formula received significantly more enteral formula volume (P = 0.011), total fat (P < 0.0005) and total energy (P = 0.017) than subjects who were provided the standard enteral formula. When controlling for the effects of enteral formula volume, total fat intake and total energy intake as confounding variables, there were no significant differences between the enteral formula groups in ICU days (P = 0.440) or hours spent on mechanical ventilation (P = 0.410).
The use of a specialised pulmonary enteral formulation did not result in any statistically significant effects on ICU days and hours on mechanical ventilation. Subjects who were on the specialised formula did receive more enteral formula volume and more total energy intake, which may be clinically important. Further clinical studies are needed to address the impact that a specialised pulmonary enteral formula has on ICU stay and ventilator hours.
富含二十碳五烯酸(EPA)和γ-亚麻酸(GLA)的肠内营养配方可能会调节炎症过程,并改善呼吸衰竭机械通气患者的结局。本研究旨在确定与接受标准肺肠内配方的机械通气患者相比,接受富含 EPA/GLA 的肺肠内配方的机械通气患者在营养指标(蛋白质摄入、能量摄入、脂肪摄入)和结局[机械通气天数、重症监护病房(ICU)天数]方面是否存在差异。
收集了在社区医院 ICU 住院的 50 名需要机械通气和肠内营养支持的成年患者的数据(标准肠内配方组 19 例;富含 EPA/GLA 的肠内配方组 31 例)。本研究涉及回顾性和前瞻性数据。
与接受标准肠内配方的患者相比,接受富含 EPA/GLA 的肠内配方的患者接受的肠内配方量显著更多(P=0.011),总脂肪(P<0.0005)和总能量(P=0.017)更多。当控制肠内配方量、总脂肪摄入量和总能量摄入量作为混杂变量的影响时,肠内配方组之间在 ICU 天数(P=0.440)或机械通气时间(P=0.410)上没有显著差异。
使用专门的肺肠内配方不会对 ICU 天数和机械通气时间产生任何统计学上的显著影响。接受专门配方的患者确实接受了更多的肠内配方量和更多的总能量摄入,这可能具有临床意义。需要进一步的临床研究来解决专门的肺肠内配方对 ICU 住院时间和呼吸机使用时间的影响。