? Objectives: 1. To assess the safety and efficacy of initial trophic enteral feeding followed by advancement to full-calorie enteral feeding vs. initial advancement to full-calorie enteral feeding management strategies in reducing mortality and morbidity in patients with ALI or ARDS 2. To assess the safety and efficacy of omega-3 fatty acid, gamma-linolenic acid, and anti-oxidant supplementation in reducing mortality and morbidity in patients with ALI or ARDS ? Hypotheses: 1. Initial trophic feeding followed by full-calorie enteral feeding will improve clinical outcomes (specifically increase the number of ventilator-free days to day 28 and decrease the 60-day, hospital mortality) in patients with ALI or ARDS by reducing systemic inflammation and the number of feeding complications as compared to early, full-calorie enteral feeding. 2. Omega-3 Fatty Acid, Gamma-linolenic acid (GLA), and anti-oxidant supplementation, as compared to placebo, will improve clinical outcomes (specifically increase the number of ventilator-free days to day 28 and decrease the 60-day, hospital mortality) in patients with ALI or ARDS by attenuating systemic inflammation.
