A 63-year-old man who was involved in a traffic accident was transferred to our hospital. He was unconscious and had a flail chest. On chest X-ray, he had a left hemopneumothorax and multiple rib fractures. After endotracheal intubation, a 16 Fr chest tube was immediately inserted, and drainage was started with negative pressure suction. Intravenous administration of sivelestat sodium hydrate and methylprednisolone was ineffective, but the Pao2/Fio2 ratio improved rapidly after enteral nutrition with an immune-enhancing diet (IED, Oxepa) was started. The patient was extubated on hospital day 34. This case suggests that an IED may be useful for the treatment of acute respiratory distress syndrome.
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