Key Point

Giving patients with sepsis or septic shock an enterally administered diet enriched with EPA, GLA, and antioxidant vitamins appears to reduce mortality and improve outcomes.

SAN FRANCISCO—An enteral diet enriched with EPA and GLA (fish and borage oils, respectively) and containing elevated levels of antioxidants appears to improve outcomes in patients with septic shock, according to the results of a study presented at the Society of Critical Care Medicine’s 35th Critical Care Congress.¹

In sepsis, inflammatory cells are activated and the inflammation spreads out of control, noted Alessandro Arruda, MD, from the Latin-American Sepsis Institute in Sao Paulo, Brazil. "The body doesn’t die from infection," he stressed. "It dies from its own response to it." Most cases of sepsis involve the lungs, and the pulmonary inflammatory process has a fundamental role in regulating the systemic inflammatory response.

Dr. Arruda and his coworkers undertook their study to investigate the therapeutic potential of an EPA/GLA/antioxidant–enriched diet for reducing 28-day mortality in patients with severe sepsis or septic shock.

One hundred sixty-five patients were enrolled and randomized to receive continuous tube feeding with an EPA/GLA/antioxidant–enriched formula or a control diet. "There was no difference between the two diets in terms of protein and carbohydrates," said Dr. Arruda. "But there was a difference in lipid composition and the presence of vitamins E and C."

Patients who were given the EPA/GLA/antioxidant–enriched diet had significant reductions in mortality (absolute reduction, 19.4%). They also had improvement in oxygenation status from baseline to days 4 and 7, more ventilator-free days (5.8 vs 13.4 in the control group), more ICU-free days (10.8 vs 4.6 in the control group), and significantly fewer episodes of organ dysfunction during follow-up.

The researchers concluded that the enriched enteral diet would be a useful adjunctive therapy in the clinical management of sepsis.

Dr. Arruda stressed the importance of beginning any sepsis treatment as early as possible. "Adequately treating a patient with sepsis is not only about doing the right thing but about doing the right thing at the right time."

—Gale Jurasek

Reference
1. Arruda A. Enteral feeding with eicosapentaenoic acid and gamma-linolenic acid as a new strategy to reduce mortality and improve outcomes in patients with severe sepsis and septic shock. Presented at: annual meeting of the Society of Critical Care Medicine; January 9, 2006; San Francisco, Calif.

Return to table of contents