Early Versus Delayed Enteral Feeding to Treat People With Acute Lung Injury or Acute Respiratory Distress Syndrome (The EDEN Study)

Inclusion Criteria: * Must meet the following three criteria within a 24-hour period of study entry: 1) PaO2/FiO2 less than or equal to 300 (if altitude is more than 1000 meters, then PaO2/FiO2 less than or equal to 300 x \[barometric pressure/760\]), 2) bilateral infiltrates (patchy, diffuse, homogeneous, or asymmetric) consistent with pulmonary edema on frontal chest radiograph, and 3) requirement for positive pressure ventilation via endotracheal tube * No clinical evidence of left-sided cardiac failure to account for bilateral pulmonary infiltrates * Intention of primary medical team to enterally feed the patient * Undergoes enteral feeding within 48 hours of meeting other inclusion criteria Exclusion Criteria: * Neuromuscular disease that impairs ability to breathe without assistance, such as cervical spinal cord injury at level C5 or higher, amyotrophic lateral sclerosis, Guillain-Barré syndrome, or myasthenia gravis * Pregnant or breastfeeding * Severe chronic respiratory disease (more information about this criterion can be found in the protocol) * Burns on greater than 40% total body surface area * Cancer or other irreversible disease or condition for which 6-month mortality is estimated to be greater than 50% (more information about this criterion can be found in the protocol) * Allogeneic bone marrow transplant in the 5 years before study entry * Patient, surrogate, or physician not committed to full support (exception: a patient will not be excluded if he/she w…