Does early enteral calories in ARDS improve outcome? A retrospective evaluation of the EDEN trial

Abstract

Summary: Objective: To determine if calories delivered within the first 6-days of mechanical ventilation for ARDS improved 60-day mortality in patients with ARDS. Design and Setting: Retrospective evaluation of randomized open label, multicenter trial; NIH ARDS Net. Patients: ARDS patients who had received mechanical ventilation for 3000 kcal group (21.5% ± 4.5 vs 5.8 ± 2.4%, P 100, Bilirubin, Phosphorus, bacteremia and ventilatory fee days appeared to be significant co-factors with a HR of 2.36 (CI: 1.45–3.85, P = 0.005) for the observed increased mortality rate seen in the low-calorie group. Conclusion: Receiving > 3000 kcal within the first 6-days of mechanical ventilation for ARDS was associated with a lower mortality. Six additional factors appear to influence higher mortality observed in the low-calorie group. Strategies to identify factors that explain this observed increased mortality and ways to reduce this risk in prospective randomized clinical trials are needed. Clinical Trials Identifier: NCT00609180 and NCT00883948.

Keywords

• Enteral nutrition
• 60-Day mortality
• Mechanical ventilation
• ARDS
• Ventilatory associated pneumonia
• Bacteremia