Caloric intake and the fat-to-carbohydrate ratio in hypercapnic acute respiratory failure: Post-hoc analysis of the PermiT trial

High-fat low-carbohydrate enteral feeding enriched with olive oil and acute respiratory failure: A double-blind, randomized, controlled trial

BACKGROUND AND AIM

The study evaluated the impact of two types of high fat diet on the outcomes of acute pulmonary failure.

METHODS

A total of 93 Ventilated acute pulmonary failure patients with enteral feeding were assigned randomly to the control group with carbohydrate-based formula (protein: 20%, fat: 30%, carbohydrate: 50%) and two study groups with fat-based formula, including group A (protein: 20%, In equal proportions of olive and sunflower oil 45%, charbohydrate:35%) and group B (protein: 20%, sunflower oil:45%, charbohydrate:35%). The diets were prescribed for 14 days.

RESULTS

In each group, 16 patients completed the study. The PaCO2 decreased significantly in the study group A compared with the control group at weaning. The risk of separation from mechanical ventilation during study period was eight times higher in the study group A than the control group. On day 10 of intervention, serum hs-CRP decreased significantly in the control group and the study group A compared to the baseline. Serum concentration of total antioxidant capacity was increased significantly in the study group A on day 10 of the intervention, but in the other two groups it was reduced. Gastrointestinal complications, including diarrhea and high gastric residual volume, were not different between the groups.

CONCLUSION

With a fat-based diet high in olive oil, more patients were weaned during the study period. This diet reduced the PaCo₂ at weaning, reduced the serum level of hs-CRP, and increased the serum level of total antioxidant capacity concentration. Fat-based diet high in sunflower oil did not have any beneficial effects on outcomes.