This article is an abstract from
information on OXEPA from Abbot Laboratories’ online website, http://www.ross.com
To view the entire article select Our Products, then OXEPA,
OXEPA is a low-carbohydrate, calorically dense
enteral nutrition product designed for the dietary management of
critically ill patients on mechanical ventilation. It contains
eicosapentaenoic acid (EPA) (from sardine oil), gamma-linolenic acid (GLA)
(from borage oil), and antioxidants. OXEPA can be used as a sole
source of nutrition for tube feeding.
- For critically ill patients on mechanical ventilation
- For critically ill patients with LUNG INJURY, such as:
pneumonia; sepsis; chest injury; multiple trauma; burns; shock and
hypoperfusion; aspiration or near-drowning; cardiopulmonary bypass;
or hyperfusion-associated lung injury.
- Complete, balanced nutrition for tube-feeding patients
- Unique patented oil blend-contains EPA from sardine oil and GLA
from borage oil
- Contains 25% of fat as MCTs for improved fat absorption
- Fortified with elevated levels of the antioxidants all-natural
vitamin E, beta-carotene, and vitamin C
- 1.5 Cal/mL, 355 Cal/8 fl oz, and a moderate osmolality of 493
- Caloric density is high to minimize the volume required to meet
- Meets 100% of RDI for 24 key vitamins and minerals in 1420
Calories (four 8-fl-oz cans)
- Lactose- and gluten-free
Clinical research using various models of
sepsis-induced ARDS has shown that nutritional intervention with a
diet (OXEPA) containing eicosapentaenoic acid (EPA) from fish oil,
gamma-linolenic acid (GLA) from borage oil, and elevated levels of
antioxidants: Improved cardiopulmonary
hemodynamics and respiratory gas exchange26 Reduced
the severity of pulmonary microvascular protein permeability27
Reduced pulmonary neutrophil recruitment28
Reduced the synthesis of proinflammatory
eicosanoids of lung injury26-28 Rapidly
displaced arachidonic acid from lung and alveolar macrophage
alveolar macrophage functions, including respiratory burst,
bactericidal, and phagocytosis31,32
Based on those preclinical findings, a prospective,
randomized, double-blinded, controlled, multicenter clinical trial33-36
was conducted to determine whether early continuous enteral feeding of
OXEPA to patients with acute lung injury (ALI)/ARDS could: Improve
oxygenation Decrease the requirements for
ventilatory support Decrease the length of
stay in the intensive care unit compared to a standard
The study was conducted in the intensive care units
of five academic teaching hospitals in the United States. One hundred
forty-six (146) patients with ARDS (as defined by the
American-European Consensus Conference) caused by sepsis/pneumonia,
trauma, or aspiration injury were enrolled in the study. Patients
meeting entry criteria were randomized and continuously tube-fed
either OXEPA or an isonitrogenous, isocaloric standard diet at a
minimum caloric delivery of 75% of basal energy expenditure x 1.3 for
at least 4 to 7 days.
These beneficial effects of OXEPA on pulmonary neutrophil
recruitment, gas exchange, requirement for mechanical ventilation,
length of intensive care unit stay, and the incidence of new organ
failures suggest that this enteral formula would be a useful adjuvant
therapy in the clinical management of patients with or at risk of
26. Murray MJ, Kumar M, Gregory TJ, et al: Select
dietary fatty acids attenuate cardiopulmonary dysfunction during acute
lung injury in pigs. Am J Physiol 1995;269:H2090-H2099.
27. Mancuso P, Whelan J, DeMichele SJ, et al:
Effects of eicosapentaenoic and g-linolenic
acid on lung permeability and alveolar macrophage eicosanoid synthesis
in endotoxic rats. Crit Care Med 1997;25:523-532.
28. Mancuso P, Whelan J, DeMichele SJ, et al:
Dietary fish oil and fish and borage oil suppress intrapulmonary
proinflammatory eicosanoid biosynthesis and attentuate pulmonary
neutrophil accumulation in endotoxic rats. Crit Care Med
29. Palombo JD, DeMichele SJ, Lydon EE, et al:
Rapid modulation of lung and liver macrophage phospholipid fatty acids
in endotoxemic rats by continuous enteral feeding with n-3 and g-linolenic
fatty acids. Am J Clin Nutr 1996;63:208-219.
30. Palombo JD, DeMichele SJ, Lydon E, Bistrian
BR: Cyclic vs continuous enteral feeding with w-3
fatty acids: Effects on modulation of phospholipid fatty acids in rat
lung and liver immune cells. JPEN 1997;21:123-132.
31. Palombo JD, DeMichele SJ, Boyce P, et al:
Alveolar macrophages (AM) maintain respiratory burst and bactericidal
function after dietary displacement of phospholipid arachidonic acid
(AA) in vivo. JPEN 1998;22(1):S4.
32. Palombo JD, DeMichele SJ, Boyce PJ, et al:
Effect of short-term enteral feeding with eicosapentaenoic and gamma-linolenic
acids on alveolar macrophage eicosanoid synthesis and bactericidal
function in rats. Crit Care Med 1999;27(9):1908-1915.
33. Gadek JM, DeMichele SJ, Karlstad MD, et al:
Effect of enteral feeding with eicosapentaenoic acid, gamma-linolenic
acid and antioxidants in patients with acute respiratory distress
syndrome. Crit Care Med 1999;27(8):1409-1420.
34. Gadek J, DeMichele S, Karlstad M, et al:
Enteral nutrition with eicosapentaenoic acid (EPA), gamma-linolenic
acid (GLA), and antioxidants reduces pulmonary inflammation and new
organ failures in patients with acute respiratory distress syndrome (ARDS).
35. Pacht E, Nelson J, DeMichele S, et al:
Specialized enteral nutrition decreases lung permeability and improves
oxygenation in patients with acute respiratory distress syndrome (ARDS).
Am J Resp Crit Care Med 1999;159(3):A694.
36. Gadek J, DeMichele S, Nelson J, et al:
Specialized enteral nutrition, Oxepa, suppresses intrapulmonary
inflammatory mediators in patients with acute respiratory distress
syndrome (ARDS). Crit Care Med 1999;27(12):A125.