Efficacy of an immuno-modulating enteral diet in patients with severe sepsis/septic shock

Abstract

Objectives: The present study investigated whether an immuno-modulating enteral diet (IMD) enriched with eicosapentaenoic acid, γ-linolenic acid, and antioxidants, evaluated to be effective in foreign countries, would be efficacy for Japanese patients with severe sepsis/septic shock requiring mechanical ventilation. Patients: The study enrolled 70 patients with severe sepsis/septic shock requiring mechanical ventilation in 10 university hospitals in Japan. Methods: Patients were randomized into two groups by the envelop system: continuously tube-fed with either the IMD (IMD group) or an isonitrogenous and isocaloric control diet (control group). The oxygenation status and Sequential Organ Failure Assessment score of the patients, blood levels of C-reactive protein (CRP) and prothrombin time international normalized ratio (PT-INR), ventilator free-days and ICU-free days, and survival rate were compared between the two groups. Results: Blood level of CRP on 14^th day in the IMD group significantly improved compared with that of the control group. Furthermore, the levels of PT-INR in the IMD group on 4^th and 7^th day were significantly higher than those of the control group. Conclusion: The efficacy of IMD useful for Japanese patients should be investigated with the larger randomized controlled trial (RCT).