Skip to main content
SpringerLink
Log in

Enteral Nutrition with Anti-inflammatory Lipids in ALI/ARDS

  • Conference paper
Intensive Care Medicine

Abstract

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are two severe forms of respiratory failure characterized by non-cardiogenic pulmonary edema and refractory hypoxemia with massive pulmonary and systemic release of pro-inflammatory mediators. The incidence of these life-threatening pulmonary diseases in the United States is currently estimated at 56–82 cases per 100,000 persons/ year [1, 2]. Current strategies adopted to treat patients with ALI and ARDS, including protective ventilation and prone positioning among others, are supportive in nature and have not shown a clear benefit in terms of mortality reduction [3].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Rubenfeld GD, Caldwell E, Peabody E, et al (2005) Incidence and outcomes of acute lung injury. N Engl J Med 353: 1685–1693

    Article  CAS  PubMed  Google Scholar 

  2. Mutlu GM, Budinger GR (2006) Incidence and outcomes of acute lung injury. N Engl J Med 354: 416–417

    Article  CAS  PubMed  Google Scholar 

  3. Brower RG, Ware LB, Berthiaume Y, Matthay MA (2001) Treatment of ARDS. Chest 120: 1347–1367

    Article  CAS  PubMed  Google Scholar 

  4. Bringham KL (1985) Metabolites of arachidonic acid in experimental lung vascular injury. Fed Proc 44: 43–45

    Google Scholar 

  5. Henderson WR Jr (1987) Lipid-derivered and other chemical mediators of inflammation in the lung. J Allergy Clin Immunol 79: 543–553

    Article  CAS  PubMed  Google Scholar 

  6. Mizock BA (2001) Nutritional support in acute lung injury and acute respiratory distress syndrome. Nutr Clin Pract 16: 319–328

    Article  Google Scholar 

  7. Mizock BA, DeMichele SJ (2004) The acute respiratory distress syndrome: role of nutritional modulation of inflammation through dietary lipids. Nutr Clin Pract 19: 563–574

    Article  PubMed  Google Scholar 

  8. Pontes-Arruda A (2007) The use of special lipids in the treatment of inflammatory lung disease. Clin Nutr Insight 33: 1–4

    Google Scholar 

  9. Mayer K, Schaefer MB, Seeger W (2006) Fish oil in the critically ill: from experimental to clinical data. Curr Opin Clin Nutr Metab Care 9: 140–148

    Article  CAS  PubMed  Google Scholar 

  10. DeMichele SJ, Wood SM, Wennberg AK (2006) A nutritional strategy to improve oxygenation and decrease morbidity in patients who have acute respiratory distress syndrome. Respir Care Clin N Am 12: 547–566

    PubMed  Google Scholar 

  11. de Alaniz MJ, Marra CA (1992) Glucocorticoid and mineralocorticoid hormones depress liver delta 5 desaturase activity through different mechanisms. Lipids 27: 599–604

    Article  PubMed  Google Scholar 

  12. Mills DE, Huang YS, Narce M, Poisson JP (1994) Psychosocial stress, catecholamines, and essential fatty acid metabolism in rats. Proc Soc Exp Biol Med 205: 56–61

    CAS  PubMed  Google Scholar 

  13. Palombo JD, DeMichele SJ, Boyce PJ, Noursalehi M, Forse RA, Bistrian BR (1998) Metabolism of dietary alpha-linolenic acid vs eicosapentaenoic acid in rat immune cell phospholipids during endotoxemia. Lipids 33: 1099–1105

    Article  CAS  PubMed  Google Scholar 

  14. Fan YY, Chapkin RS (1998) Importance of dietary gamma-linolenic acid in human health and nutrition. J Nutr 128: 1411–1414

    CAS  PubMed  Google Scholar 

  15. Karlstad MD, DeMichele SJ, Leathem WD, et al (1993) Effect of intravenous lipid emulsions enriched with gamma-linolenic acid on plasma n-6 fatty acids and prostaglandin biosynthesis after burn and endotoxin injury in rats. Crit Care Med 21: 1740–1749

    Article  CAS  PubMed  Google Scholar 

  16. Johnson MM, Swan DD, Surette ME, et al (1997) Dietary supplementation with gamma-linolenic acid alters fatty acid content and eicosanoid production in healthty humans. J Nutr 127: 1435–1444

    CAS  PubMed  Google Scholar 

  17. Wanten GJA, Calder PC (2007) Immune modulation by parenteral lipid emulsions. Am J Clin Nutr 85: 1171–1184

    CAS  PubMed  Google Scholar 

  18. Deckelbaum RJ, Worgall TS, Seo T (2006) n-3 Fatty acids and gene expression. Am J Clin Nutr 83 (Suppl): S1520–S1525

    Google Scholar 

  19. Singer P, Shapiro H, Theilla M, Anbar R, Singer J, Cohen J (2008) Anti-inflammatory properties of omega-3 fatty acids and critical illness: novel mechanisms and an integrative perspective. Intensive Care Med 34: 1580–1592

    Article  CAS  PubMed  Google Scholar 

  20. Denys A, Hichami A, Khan NA (2005) n-3 PUFAs modulate T-cell activation via protein kinase C-alpha and —epsilon and the NF-kappaB signaling pathway. J Lipid Res 46: 752–758

    Article  CAS  PubMed  Google Scholar 

  21. Sperling RI, Benincaso AI, Knoell CT, et al (1993) Dietary omega-3 polyunsaturated fatty acids inhibit phosphoinositide formation and chemotaxis in neutrophils. J Clin Invest 91: 651–660

    Article  CAS  PubMed  Google Scholar 

  22. Madani S, Hichami A, Cherkaoui-Malki M, Khan NA (2004) Diacylglycerols containing omega-3 and omega-6 fatty acids bind to RasGRP and modulate MAP kinase activation. J Biol Chem 279: 1176–1183

    Article  CAS  PubMed  Google Scholar 

  23. Chen H, Li D, Chen J, et al (2003) EPA and DHA attenuate ox-LDL-induced expression of adhesion molecules in human coronary artery endothelial cells via protein kinase B pathway. J Mol Cell Cardiol 35: 769–775

    Article  CAS  PubMed  Google Scholar 

  24. Fialkow L, Fochesatto Filho L, Bozzetti MC, et al (2006) Neutrophil apoptosis: a marker of disease severity in sepsis and sepsis-induced acute respiratory distress syndrome. Crit Care 10: R155

    Article  PubMed  Google Scholar 

  25. Annane D, Bellissant E, Cavaillon JM (2005) Septic shock. Lancet 365: 63–78

    Article  CAS  PubMed  Google Scholar 

  26. Willoughby DA, Moore AR, Colville-Nash PR, Gilroy D (2000) Resolution of inflammation. Int J Immunopharmacol 22: 1131–1135

    Article  CAS  PubMed  Google Scholar 

  27. Savill JS, Wyllie AH, Henson JE, Walport MJ, Henson PM, Haslett C (1989) Macrophage phagocytosis of aging neutrophils in inflammation. Programmed cell death in the neutrophil leads to its recognition by macrophages. J Clin Invest 83: 865–875

    Article  CAS  PubMed  Google Scholar 

  28. Haslett C (1992) Resolution of acute inflammation and the role of apoptosis in the tissue fate of granulocytes. Clin Sci (Lond) 83: 639–648

    CAS  Google Scholar 

  29. Serhan CN, Savill J (2005) Resolution of inflammation: the beginning programs the end. Nat Immunol 6: 1191–1197

    Article  CAS  PubMed  Google Scholar 

  30. Ward C, Walker A, Dransfield I, Haslett C, Rossi AG (2004) Regulation of granulocyte apoptosis by NF-κB. Biochem Soc Trans 32: 465–467

    Article  CAS  PubMed  Google Scholar 

  31. Freire-de-Lima CG, Xiao YQ, Gardai SJ, Bratton DL, Schiemann WP, Henson PM (2006) Apoptotic cells, through transforming growth factor-β, coordinately induce anti-inflammatory and suppress pro-inflammatory eicosanoid and NO synthesis in murine macrophages. J Biol Chem 281: 38376–38384

    Article  CAS  PubMed  Google Scholar 

  32. Lucas M, Stuart LM, Savill J, Lacy-Hullbert A (2003) Apoptotic cells and innate stimuli combine to regulate macrophage cytokine secretion. J Immunol 171: 2610–2615

    CAS  PubMed  Google Scholar 

  33. Serhan CN, Clish CB, Brannon J, Colgan SP, Chiang N, Cronert K (2000) Novel functional sets of lipid-derived mediators with anti-inflammatory actions generated from omega-3 fatty acids via cyclooxygenase 2-nonsteroidal anti-inflammatory drugs and transcellular processing. J Exp Med 192: 1197–1204

    Article  CAS  PubMed  Google Scholar 

  34. Serhan CN, Hong S, Gronert K, et al (2002) Resolvins: a family of bioactive products of omega-3 fatty acid transformation circuits initiated by aspirin treatment that counter proinflammation signals. J Exp Med 196: 1025–1037

    Article  CAS  PubMed  Google Scholar 

  35. Mancuso P, Whelan J, DeMichele SJ, Snider CC, Guszcza JA, Karlstad MD (1997) Dietary fish oil and fish and borage oil suppress intrapulmonary proinflammatory eicosanoid biosynthesis and attenuate pulmonary neutrophil accumulation in endotoxic rats. Crit Care Med 25: 1198–1206

    Article  CAS  PubMed  Google Scholar 

  36. Mancuso P, Whelan J, DeMichele SJ, et al (1997) Effects of eicosapentaenoic and gammalinolenic acid on lung permeability and alveolar macrophage eicosanoid synthesis in endotoxic rats. Crit Care Med 25: 523–532

    Article  CAS  PubMed  Google Scholar 

  37. Murray MJ, Kumar M, Gregory TJ, Banks PL, Tazelaar HD, DeMichele SJ (1995) select dietary fatty acids attenuate cardiopulmonary dysfunction during acute lung injury in pigs. Am J Physiol 269: H2090–H2099

    CAS  PubMed  Google Scholar 

  38. Murray MJ, Kanazi G, Moukabary K, Tazelaar HD, DeMichele SJ (2000) Effects of eicosapentaenoic and gamma-linolenic acids (dietary lipids) on pulmonary surfactant composition and function during porcine endotoxemia. Chest 117: 1720–1727

    Article  CAS  PubMed  Google Scholar 

  39. Palombo JD, DeMichele SJ, Lydon E, Bistrian BR (1997) Cyclic vs continuous enteral feeding with omega-3 and gamma-linolenic fatty acids: effects on modulation of phospholipid fatty acids in rat lung and liver immune cells. JPEN J Parenter Enteral Nutr 21: 123–132

    Article  CAS  PubMed  Google Scholar 

  40. Palombo JD, DeMichele SJ, Boyce PJ, et al (1999) Effect of short-term enteral feeding with eicosapentaenoic and gamma-linolenic acids on alveolar macrophage eicosanoid synthesis and bactericidal function in rats. Crit Care Med 27: 1908–1915

    Article  CAS  PubMed  Google Scholar 

  41. Palombo JD, DeMichele SJ, Lyndon EE, et al (1996) Rapid modulation of lung and liver macrophage phospholipid fatty acids in endotoxemic rats by continuous Enteral feeding with n-3 and gamma-linolenic fatty acids. Am J Clin Nutr 63: 208–219

    CAS  PubMed  Google Scholar 

  42. Gadek JE, DeMichele SJ, Karlstad MD, et al (1999) Effect of enteral feeding with eicosapentaenoic acid, gamma-linolenic acid, and antioxidants in patients with acute respiratory distress syndrome. Enteral nutrition in ARDS study group. Crit Care Med 27: 1409–1420

    Article  CAS  PubMed  Google Scholar 

  43. Singer P, Theilla M, Fisher H, et al (2006) Benefit of an enteral diet enriched with eicosapentaenoic acid and gamma-linolenic acid in ventilated patients with acute lung injury. Crit Care Med 34: 1033–1038

    Article  CAS  PubMed  Google Scholar 

  44. Pontes-Arruda A, Aragão AM, Albuquerque JD (2006) The effects of enteral feeding with eicosapentaenoic acid, gamma-linolenic acid and antioxidants in mechanically ventilated patients with severe sepsis and septic shock. Crit Care Med 34: 2325–2333

    Article  CAS  PubMed  Google Scholar 

  45. Mayes T, Gottschlich M, Carman B, et al (2005) An evaluation of the safety and efficacy of an anti-inflammatory, pulmonary enteral formula in the treatment of pediatric burn patients with respiratory failure. Nutr Clin Prac 20: 30–31

    Google Scholar 

  46. Theilla M, Singer P, Cohen, DeKeyser F (2007) A diet enriched with eicosapentaenoic acid, gamma-linolenic acid and antioxidants in the incidence of new pressure ulcer formation in critically ill patients with acute lung injury: a randomized, prospective, controlled study. Clin Nutr 26: 752–757

    CAS  PubMed  Google Scholar 

  47. Pontes-Arruda A, DeMichele SJ, Seth A, Singer P (2008) The use of an inflammation-modulating diet in patients with acute lung injury and acute respiratory distress syndrome: a meta-analysis of outcome data. JPEN J Parenter Enteral Nutr 32: 596–605

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Intensive Care Nutrition Department, Fernandes Tavora Hospital, Rua Ildefonso Albano 777/403, Fortaleza, Ceara, 60115-000, Brazil

    A. Pontes-Arruda

  2. Strategic and International R & D, Abbott Nutrition, 3300 Stelzer Road, Columbus, OH, 43219, USA

    S. J. DeMichele

Authors
  1. A. Pontes-Arruda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. J. DeMichele
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Intensive Care Erasme Hospital, Universitée libre de Bruxelles, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent (Head) (Head)

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Pontes-Arruda, A., DeMichele, S.J. (2009). Enteral Nutrition with Anti-inflammatory Lipids in ALI/ARDS. In: Vincent, JL. (eds) Intensive Care Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-92278-2_64

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-92278-2_64

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-92277-5

  • Online ISBN: 978-0-387-92278-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation