TY  - JOUR
T1  - ENteral omega-3 fatty acid, γ-linolenic acid, and antioxidant supplementation in acute lung injury
AU  - Rice TW, Wheeler AP, Thompson B, et al
Y1  - 2011/10/12
N1  - 10.1001/jama.2011.1435
JO  - JAMA
SP  - 1574
EP  - 1581
VL  - 306
IS  - 14
N2  - Context 
                  The omega-3 (n-3) fatty acids docosahexaenoic acid and eicosapentaenoic acid, along with γ-linolenic acid and antioxidants, may modulate systemic inflammatory response and improve oxygenation and outcomes in patients with acute lung injury.Objective 
                  To determine if dietary supplementation of these substances to patients with acute lung injury would increase ventilator-free days to study day 28.Design, Setting, and Participants 
                  The OMEGA study, a randomized, double-blind, placebo-controlled, multicenter trial conducted from January 2, 2008, through February 21, 2009. Participants were 272 adults within 48 hours of developing acute lung injury requiring mechanical ventilation whose physicians intended to start enteral nutrition at 44 hospitals in the National Heart, Lung, and Blood Institute ARDS Clinical Trials Network. All participants had complete follow-up.Interventions 
                  Twice-daily enteral supplementation of n-3 fatty acids, γ-linolenic acid, and antioxidants compared with an isocaloric control. Enteral nutrition, directed by a protocol, was delivered separately from the study supplement.Main Outcome Measure 
                  Ventilator-free days to study day 28.Results 
                  The study was stopped early for futility after 143 and 129 patients were enrolled in the n-3 and control groups. Despite an 8-fold increase in plasma eicosapentaenoic acid levels, patients receiving the n-3 supplement had fewer ventilator-free days (14.0 vs 17.2; P = .02) (difference, −3.2 [95% CI, −5.8 to −0.7]) and intensive care unit–free days (14.0 vs 16.7; P = .04). Patients in the n-3 group also had fewer nonpulmonary organ failure–free days (12.3 vs 15.5; P = .02). Sixty-day hospital mortality was 26.6% in the n-3 group vs 16.3% in the control group (P = .054), and adjusted 60-day mortality was 25.1% and 17.6% in the n-3 and control groups, respectively (P = .11). Use of the n-3 supplement resulted in more days with diarrhea (29% vs 21%; P = .001).Conclusions 
                  Twice-daily enteral supplementation of n-3 fatty acids, γ-linolenic acid, and antioxidants did not improve the primary end point of ventilator-free days or other clinical outcomes in patients with acute lung injury and may be harmful.Trial Registration 
                  clinicaltrials.gov Identifier: NCT00609180
SN  - 0098-7484
M3  - doi: 10.1001/jama.2011.1435
UR  - http://dx.doi.org/10.1001/jama.2011.1435
ER  -