Initial trophic vs full enteral feeding in patients with acute lung injury: the EDEN randomized trial.

Study answer

What this study found

Initial trophic feeding did not improve the main clinical outcomes compared with full feeding. Ventilator-free days through day 28 were essentially identical: 14.9 versus 15.0, difference -0.1 (95% CI, -1.4 to 1.2; P=.89), and 60-day mortality was also similar at 23.2% versus 22.2% (difference 1.0%, 95% CI, -4.1% to 6.3%; P=.77). Trophic feeding produced fewer gastrointestinal intolerance events, including regurgitation, vomiting, elevated gastric residual volumes, and constipation, but diarrhea, aspiration, and abdominal distention were not meaningfully different. Time to reach goal feeding…

Study & population

Multicenter randomized trial at 44 hospitals in the NHLBI ARDS Clinical Trials Network.

Intervention

Adults with acute lung injury were randomized to initial trophic enteral feeding or full enteral feeding.

Key limitation

The intervention was short-term and focused on the first 6 days of ventilation, so it does not address longer-term feeding strategies.

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Original abstract