Article

One year outcomes of initial trophic vs full enteral feeding in acute lung injury patients: prospective follow-up ofthe EDEN randomized trial

Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, MD 21205, USA.
BMJ (online) (Impact Factor: 16.38). 03/2013; 346:f1532. DOI: 10.1136/bmj.f1532
Source: PubMed

ABSTRACT 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.

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