Physical and cognitive performance of patients with acute lung injury 1 year after initial trophic versus full enteral feeding EDEN Trial follow-up

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

Research output: Contribution to journalArticle

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, andcognitive 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%)and66%(25%)(P=0.011 for differencebetweenassessments), 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 6days after randomization on survivors' percent predicted for 6-minutewalk 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.

Original languageEnglish (US)
Pages (from-to)567-576
Number of pages10
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume188
Issue number5
DOIs
StatePublished - Sep 1 2013

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Acute Lung Injury
Enteral Nutrition
Survivors
Random Allocation
Concept Formation
Executive Function
Artificial Respiration
Intensive Care Units
Longitudinal Studies
Language
Lung
Cognitive Dysfunction
Proteins

Keywords

  • Cognition disorders
  • Exercise tests
  • Follow-up studies
  • Muscle strength
  • Neuropsychological tests

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Physical and cognitive performance of patients with acute lung injury 1 year after initial trophic versus full enteral feeding EDEN Trial follow-up. / Needham, Dale; Dinglas, Victoriano; Morris, Peter E.; Jackson, James C.; Hough, Catherine L.; Mendez Tellez, Pedro A; Wozniak, Amy W.; Colantuoni, Elizabeth Ann; Ely, E. Wesley; Rice, Todd W.; Hopkins, Ramona O.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 188, No. 5, 01.09.2013, p. 567-576.

Research output: Contribution to journalArticle

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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, andcognitive 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{\%})and66{\%}(25{\%})(P=0.011 for differencebetweenassessments), 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 6days after randomization on survivors' percent predicted for 6-minutewalk 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.",
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AU - Needham, Dale

AU - Dinglas, Victoriano

AU - Morris, Peter E.

AU - Jackson, James C.

AU - Hough, Catherine L.

AU - Mendez Tellez, Pedro A

AU - Wozniak, Amy W.

AU - Colantuoni, Elizabeth Ann

AU - Ely, E. Wesley

AU - Rice, Todd W.

AU - Hopkins, Ramona O.

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N2 - 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, andcognitive 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%)and66%(25%)(P=0.011 for differencebetweenassessments), 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 6days after randomization on survivors' percent predicted for 6-minutewalk 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.

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