Pros：高齢/痩せの重症ARDS患者を考えれば，これもあり

Achieving full feedings in patients with ARDS

急性呼吸窮迫症候群（ARDS）患者における栄養療法において，既存の無作為化比較試験からはfull feedingとtrophic feedingのいずれが生命予後改善や人工呼吸器離脱に有用かは不明である。既存の研究には，ARDSの重症度が軽症であることや投与エネルギー量が不足している可能性などの問題点が存在する。また，欧米と比較して高齢・低BMIの日本の患者群に欧米の試験結果を外挿できるかは不明である。本邦のICUにおいてfull feedingの有用性を評価する可能性は残っている。

No randomized controlled trial （RCT） has shown superiority of full feedings compared to trophic feeds in terms of mortality or duration of mechanical ventilation in patients with acute respiratory distress syndrome （ARDS）. It is of concern that these RCTs include few patients with severe lung injury. There is also a possibility that the number of calories given is insufficient even in the full feeding group, given the increased energy demands in patients with ARDS. Patients included in the RCTs could be younger and relatively obese compared to those in Japan, suggesting difficulties in extrapolating the results to the Japanese population. Additional trials may be needed to assess the efficacy of full feedings in Japanese ICUs.