COLUMBUS, Ohio -- A special diet formula rich in antioxidants and plant and fish oils seems to reduce the harmful effects of a serious respiratory problem.
Patients with acute respiratory distress syndrome (ARDS) who were given the special liquid formula via a feeding tube spent an average of five fewer days relying on a ventilator and five fewer days in the intensive care unit. Also, the same patients developed significantly fewer failures in other organs.
"ARDS is a complication of many other respiratory-related diseases which damage the lungs," said James Gadek, co-author of the study and a professor of internal medicine at Ohio State University. "The diet we gave patients reduced inflammation in the lungs and, just as important, had no apparent side effects."
ARDS is often a serious side effect of lung diseases or injuries such as pneumonia, or smoke or chemical inhalation. The lungs fill up with fluid, making it difficult for the patient to breathe.
The research appeared in a recent issue of the journal Critical Care Medicine. The study included 98 patients from the intensive care units of five teaching hospitals.
The researchers gave a diet of antioxidants and two fatty acids -- eicosapentaenoic acid (fish oil) and gamma-linolenic acid (oil from a borage plant) -- to 51 patients, and a placebo diet to 47 patients. Antioxidants included beta-carotene and the vitamins A and C.
Each patient received the mixture via a tube to the stomach for at least four to seven days. Initially, all patients breathed with the help of a respirator.
The researchers measured breathing difficulty and the volume of fluid in each patient's lungs four and seven days after starting the diet. They also looked at the development of failure in other organs.
The researchers found a decrease in the rate of failure of other organs in patients given the diet. Only 8 percent of these patients developed failure in one or more organs during the study, while more than three times that many on the control diet developed organ failures that were not present when the feedings began.
About half of the people who develop ARDS die from the disorder -- often because of complications in organs other than the lungs. But this diet appears to counteract several of the negative effects of ARDS, by essentially thwarting the efforts of the immune system.
ARDS stems from the body's attempts to protect itself from further injury. Neutrophils -- white blood cells produced by the immune system in response to inflammation -- accumulate in the lungs.
"This protective effort ultimately damages the body," Gadek said. "As a result, the patient gets a massive accumulation of white blood cells in the lungs, and the neutrophils start killing lung cells."
The use of fatty acids prevents the immune system from producing an excessive amount of neutrophils.
This research was supported in part by a grant from Ross Products, Abbott Laboratories. The combination diet used for this study is sold under the brand name Oxepa and is produced by Ross Products.
Gadek conducted this study with researchers from Ross Products Division, Abbott Laboratories in Columbus; the University of Tennessee Medical Center; the University of Pittsburgh Medical Center; the University of California-Davis Medical Center; the SCIREX Corporation; and the Mayo Clinic.
Contact: James Gadek, 614-293-4925
Written by Holly Wagner, 614-292-8310; Wagner.235@osu.edu
Journal
Critical Care Medicine