Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, MD 21205, USA.
BMJ. 2013 Mar 19;346:f1532. doi: 10.1136/bmj.f1532.
To evaluate the effect of initial low energy permissive underfeeding ("trophic feeding") versus full energy enteral feeding ("full feeding") on physical function and secondary outcomes in patients with acute lung injury.
Prospective longitudinal follow-up evaluation of the NHLBI ARDS Clinical Trials Network's EDEN trial
41hospitals in the United States.
525 patients with acute lung injury.
Randomised assignment to trophic or full feeding for up to six days; thereafter, all patients still receiving mechanical ventilation received full feeding.
Blinded assessment of the age and sex adjusted physical function domain of the SF-36 instrument at 12 months after acute lung injury. Secondary outcome measures included survival; physical, psychological, and cognitive functioning; quality of life; and employment status at six and 12 months.
After acute lung injury, patients had substantial physical, psychological, and cognitive impairments, reduced quality of life, and impaired return to work. Initial trophic versus full feeding did not affect mean SF-36 physical function at 12 months (55 (SD 33) v 55 (31), P=0.54), survival to 12 months (65% v 63%, P=0.63), or nearly all of the secondary outcomes.
In survivors of acute lung injury, there was no difference in physical function, survival, or multiple secondary outcomes at 6 and 12 month follow-up after initial trophic or full enteral feeding.
NCT No 00719446.
评估初始低能量允许性低喂养（“营养喂养”）与全能量肠内喂养（“全喂养”）对急性肺损伤患者的身体功能和次要结局的影响。
对 NHLBI ARDS 临床试验网络的 EDEN 试验进行前瞻性纵向随访评估。
美国 41 家医院。
525 名急性肺损伤患者。
随机分配到营养喂养或全喂养，为期 6 天；此后，所有仍接受机械通气的患者均接受全喂养。
在急性肺损伤后 12 个月，使用 SF-36 工具评估年龄和性别调整后的身体功能域。次要结局指标包括生存；身体、心理和认知功能；生活质量；以及 6 个月和 12 个月时的就业状况。
急性肺损伤后，患者的身体、心理和认知功能受损严重，生活质量降低，重返工作岗位的能力受损。初始营养喂养与全喂养在 12 个月时对 SF-36 身体功能的平均评分（55（33）v 55（31），P=0.54）、12 个月时的生存率（65% v 63%，P=0.63）或几乎所有次要结局均无影响。
在急性肺损伤幸存者中，初始营养喂养或全喂养后 6 个月和 12 个月的随访中，身体功能、生存率或多个次要结局均无差异。
NCT 00719446。
