Journal Article

Physical and Cognitive Performance of Patients with Acute Lung Injury 1 Year after Initial Trophic versus Full Enteral Feeding. EDEN Trial Follow-up

Ely, E. Wesley, Morris, Peter E., Rice, Todd W., Mendez-Tellez, Pedro A., Hough, Catherine L., Hopkins, Ramona O., Jackson, James C., Needham, Dale M., Dinglas, Victor D., Colantuoni, Elizabeth, Wozniak, Amy W.

2013

Overview

Abstract Rationale We hypothesized that providing patients with acute lung injury two different protein/calorie nutritional strategies in the intensive care unit may affect longer-term physical and cognitive performance. Objectives To assess physical and cognitive performance 6 and 12 months after acute lung injury, and to evaluate the effect of trophic versus full enteral feeding, provided for the first 6 days of mechanical ventilation, on 6-minute-walk distance, cognitive impairment, and secondary outcomes. Methods A prospective, longitudinal ancillary study of the ARDS Network EDEN trial evaluating 174 consecutive survivors from 5 of 12 centers. Blinded assessments of patients’ arm anthropometrics, strength, pulmonary function, 6-minute-walk distance, and cognitive status (executive function, language, memory, verbal reasoning/concept formation, and attention) were performed. Measurements and Main Results At 6 and 12 months, respectively, the mean (SD) percent predicted for 6-minute-walk distance was 64% (22%) and 66% (25%) (P = 0.011 for difference between assessments), and 36 and 25% of survivors had cognitive impairment (P = 0.001). Patients performed below predicted values for secondary physical tests with small improvement from 6 to 12 months. There was no significant effect of initial trophic versus full feeding for the first 6 days after randomization on survivors’ percent predicted for 6-minute-walk distance, cognitive impairment status, and all secondary outcomes. Conclusions EDEN trial survivors performed below predicted values for physical and cognitive performance at 6 and 12 months, with some improvement over time. Initial trophic versus full enteral feeding for the first 6 days after randomization did not affect physical and cognitive performance.

• Publisher: Oxford University Press,American Thoracic Society
• Subject: Activities of Daily Living / Acute Lung Injury - complications / Acute Lung Injury - therapy / Anesthesia / Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy / Biological and medical sciences / Cognition / Cognition & reasoning / Cognition Disorders - etiology / Cognition Disorders - prevention & control / Cognitive ability / Critical Care - methods / Delirium / Enteral nutrition / Enteral Nutrition - methods / Female / Follow-Up Studies / Humans / Intensive care / Intensive care medicine / Longitudinal studies / Male / Medical records / Medical sciences / Middle Aged / Muscle strength / Neuropsychological Tests / Patients / Pneumology / Time Factors / Treatment Outcome / Ventilators