impact of omega-3 fatty acids enriched total parenteral nutrition on blood chemistry and inflammatory markers in septic patients

Gultekin, Gamze; Şahin, Habibe; İnanç, Neriman; Uyanik, Fatma; Ok, Engin

doi:10.12669/pjms.302.3957

Cited by 24 publications

(58 citation statements)

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“…Brand-name formulae used included Omegaven [29, 32–34, 38, 41], Oxepa [31, 36, 37], Impact [28, 30], and Lipoplus [43]. Available data on the contents of all brand-name intervention and control formulae are given in Additional file 1: Tables S4–S5.…”

Section: Resultsmentioning

confidence: 99%

Omega-3 supplementation in patients with sepsis: a systematic review and meta-analysis of randomized trials

Sharma

McIntyre

et al. 2017

Ann. Intensive Care

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BackgroundNutritional supplementation of omega-3 fatty acids has been proposed to modulate the balance of pro- and anti-inflammatory mediators in sepsis. If proved to improve clinical outcomes in critically ill patients with sepsis, this intervention would be easy to implement. However, the cumulative evidence from several randomized clinical trials (RCTs) remains unclear.MethodsWe searched the Cochrane Library, MEDLINE, and EMBASE through December 2016 for RCTs on parenteral or enteral omega-3 supplementation in adult critically ill patients diagnosed with sepsis or septic shock. We analysed the included studies for mortality, intensive care unit (ICU) length of stay, and duration of mechanical ventilation, and used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the quality of the evidence for each outcome.ResultsA total of 17 RCTs enrolling 1239 patients met our inclusion criteria. Omega-3 supplementation compared to no supplementation or placebo had no significant effect on mortality [relative risk (RR) 0.85; 95% confidence interval (CI) 0.71, 1.03; P = 0.10; I 2 = 0%; moderate quality], but significantly reduced ICU length of stay [mean difference (MD) −3.79 days; 95% CI −5.49, −2.09; P < 0.0001, I 2 = 82%; very low quality] and duration of mechanical ventilation (MD −2.27 days; 95% CI −4.27, −0.27; P = 0.03, I 2 = 60%; very low quality). However, sensitivity analyses challenged the robustness of these results.ConclusionOmega-3 nutritional supplementation may reduce ICU length of stay and duration of mechanical ventilation without significantly affecting mortality, but the very low quality of overall evidence is insufficient to justify the routine use of omega-3 fatty acids in the management of sepsis.Electronic supplementary materialThe online version of this article (doi:10.1186/s13613-017-0282-5) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Omega-3 supplementation in patients with sepsis: a systematic review and meta-analysis of randomized trials

Sharma

McIntyre

et al. 2017

Ann. Intensive Care

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“…Six studies cited significantly lower levels of IL‐6 with FO than with SO, MCT/LCT, or saline . In contrast, 10 studies found no significant differences in levels of IL‐6 with FO vs SO, MCT/LCT, OO, or control nutrition …”

Section: Resultsmentioning

confidence: 98%

Fish Oil–Containing Lipid Emulsions in Adult Parenteral Nutrition: A Review of the Evidence

Abbasoğlu

Hardy

Manzanares

et al. 2017

J Parenter Enteral Nutr

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Background. There is evidence from laboratory and animal studies that fish oil-containing intravenous lipid emulsions (FOCIVLEs) have a beneficial effect on inflammation and the immune response, suggesting a possible clinical benefit. Clinical studies of FOC-IVLEs have reported mixed results. The aim of this review is to present findings from recent randomized controlled clinical trials and other quality clinical studies investigating the effects of administering intravenous fish oil alone or as part of a multilipid emulsion and to examine the quality of these studies in an objective, evidence-based manner. Methods. Studies comparing FOCIVLEs with other IVLEs in adults were included. Thirty-four clinical studies were evaluated: 19 investigated levels of inflammatory and immune markers as an endpoint; 13 investigated rates of infection or sepsis; 3 investigated clinical outcomes in septic patients; and 29 investigated general clinical outcomes. Results. There was conflicting evidence for a beneficial effect of fish oil on levels of inflammatory and immune markers and some evidence that fish oil decreased the rate of postoperative atrial fibrillation. Studies generally reported few statistical differences in clinical outcomes and rates of infection and sepsis with FOC-IVLEs as compared with other IVLEs. The quality of reporting was generally poor, and the presented evidence for comparisons between FOC-IVLEs and other IVLEs was inconclusive or weak. Conclusions. There is very little high-quality evidence that FOC-IVLEs have a more beneficial effect than other IVLEs on clinical outcomes in adult patients. (JPEN J Parenter Enteral Nutr. 2017;00:1-13)

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“…En el análisis multivariante, la prealbúmina se relacionó con tres patrones de EL, pero en ninguno de ellos con significación estadística. Pocos estudios analizan la relación entre EL y prealbúmina y los que lo hacen no encuentran asociaciones significativas (28,30). Por lo tanto, el parámetro prealbúmina no parece ser crítico para seleccionar la EL a administrar, aunque harían falta más estudios que analizaran específicamente la prealbúmina para confirmar los resultados.…”

Section: Discussionunclassified

Selección De Emulsiones Lipídicas en Nutrición Parenteral: Parametros Bioquimicos Y Hematológicos.

Talaverón

Leiva‐Badosa

Novak³

et al. 2017

Nutr Hosp

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Introducción: El patrón de ácidos grasos (AG) de las emulsiones lipídicas (EL) utilizadas en Nutrición Parenteral (NP) condiciona diferentes respuestas fisiológicas.Objetivos: Valorar la adecuación de un protocolo clínico no restringido en la elección de EL mediante el estudio de parámetros bioquímicos y hematológicos específicos (PBHE) al inicio de la NP.Métodos: Estudio observacional retrospectivo de 4 años. Se recogieron variables demográficas, clínicas, nutricionales y analíticas al inicio de la NP. En pacientes con valores iniciales de los PBHE, se hizo un análisis univariante y multivariante para estudiar la asociación entre sus valores iniciales y el patrón lipídico utilizado.Resultados: De los 1558 pacientes, 460 pacientes (29,5%) tenían PBHE al inicio de la NP y utilizaron mayoritariamente las combinaciones soja (AS)+triglicéridos de cadena media (MCT)+oliva (AO)+pescado (AP) (37,4%) y AS+MCT+AO (35,6%). Se encontraron diferencias estadísticamente significativas en el patrón EL utilizado entre los pacientes con y sin PBHE: patrón de AG con AP 44,8% vs 39,5%, respectivamente.Las situaciones clínicas con proteína C-reactiva (PCR) elevada se asociaron con mayor uso de EL con AP: AS+AO+AP (OR:4,52 [IC 95%: 1,43-13,91] y AS+MCT+AO+AP (OR:3,34 [IC 95%: 2,10-5,33]). En situaciones clínicas complejas asociadas con paciente crítico se utilizaron EL con MCT: fracaso hepático (AS+MCT OR:2,42 [IC95%: 1,03-5,68]) y fracaso renal (AS+MCT+AP OR:3.34 [IC95%: 1,12-9.99]).Conclusiones: La inclusión protocolizada de PBHE al inicio de la NP permite complementar criterios clínicos y metabólicos en la elección de la EL.

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impact of omega-3 fatty acids enriched total parenteral nutrition on blood chemistry and inflammatory markers in septic patients

Cited by 24 publications

References 0 publications

Omega-3 supplementation in patients with sepsis: a systematic review and meta-analysis of randomized trials

Omega-3 supplementation in patients with sepsis: a systematic review and meta-analysis of randomized trials

Fish Oil–Containing Lipid Emulsions in Adult Parenteral Nutrition: A Review of the Evidence

Selección De Emulsiones Lipídicas en Nutrición Parenteral: Parametros Bioquimicos Y Hematológicos.

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