• C Galbán, J C Montejo, A Mesejo, P Marco, S Celaya, J M Sánchez-Segura, M Farré, and D J Bryg.
• Complejo Hospitalario Universitario, Santiago de Compostela, La Coruña, Spain.
• Crit. Care Med. 2000 Mar 1;28(3):643-8.

ObjectiveTo determine whether early enteral feeding in a septic intensive care unit (ICU) population, using a formula supplemented with arginine, mRNA, and omega-3 fatty acids from fish oil (Impact), improves clinical outcomes, when compared with a common use, high protein enteral feed without these nutrients.DesignA prospective, randomized, multicentered trial.SettingICUs of six hospitals in Spain.PatientsOne hundred eighty-one septic patients (122 males, 59 females) presenting for enteral nutrition in an ICU.InterventionsSeptic ICU patients with Acute Physiology and Chronic Health Evaluation (APACHE) II scores of > or =10 received either an enteral feed enriched with arginine, mRNA, and omega-3 fatty acids from fish oil (Impact), or a common use, high protein control feed (Precitene Hiperproteico).Measurements And Main ResultsOne hundred seventy-six (89 Impact patients, 87 control subjects) were eligible for intention-to-treat analysis. The mortality rate was reduced for the treatment group compared with the control group (17 of 89 vs. 28 of 87; p < .05). Bacteremias were reduced in the treatment group (7 of 89 vs. 19 of 87; p = .01) as well as the number of patients with more than one nosocomial infection (5 of 89 vs. 17 of 87; p = .01). The benefit in mortality rate for the treatment group was more pronounced for patients with APACHE II scores between 10 and 15 (1 of 26 vs. 8 of 29; p = .02).ConclusionsImmune-enhancing enteral nutrition resulted in a significant reduction in the mortality rate and infection rate in septic patients admitted to the ICU. These reductions were greater for patients with less severe illness.

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