A randomized controlled trial investigating the effects of parenteral fish oil on survival outcomes in critically ill patients with sepsis: A pilot study

Journal of Parenteral and Enteral Nutrition

Volumn 39, Issue 3, 2015, Pages 301-312

  Hall, Thomas C ^a   Bilku, Dilraj K ^a   Al Leswas, Dhya ^a   Neal, Christopher P ^a   Horst, Cindy ^a   Cooke, Jill ^a   Metcalfe, Matthew S ^b   Dennison, Ashley R ^a  

^a LEICESTER GENERAL HOSPITAL   (United Kingdom)

^b NONE

Author keywords

critical illness; fish oil; intensive care; randomized controlled trial; sepsis; 3

Indexed keywords

C REACTIVE PROTEIN; FISH OIL; OMEGA 3 FATTY ACID;

ADULT; ARTICLE; CLINICAL ARTICLE; CONTROLLED STUDY; CRITICALLY ILL PATIENT; DISEASE MARKER; DISEASE SEVERITY; DRUG EFFECT; DRUG SAFETY; FEMALE; HUMAN; INTENSIVE CARE UNIT; LENGTH OF STAY; MALE; MIDDLE AGED; MORTALITY; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; SEPSIS; SEQUENTIAL ORGAN FAILURE ASSESSMENT SCORE; SURVIVAL; TREATMENT OUTCOME; AGED; COMPLICATION; CRITICAL ILLNESS; INFLAMMATION; METABOLISM; MULTIPLE ORGAN FAILURE; PARENTERAL NUTRITION; PATHOLOGY; PILOT STUDY;

AGED; C-REACTIVE PROTEIN; CRITICAL ILLNESS; FATTY ACIDS, OMEGA-3; FEMALE; FISH OILS; HUMANS; INFLAMMATION; INTENSIVE CARE UNITS; LENGTH OF STAY; MALE; MIDDLE AGED; MULTIPLE ORGAN FAILURE; PARENTERAL NUTRITION; PILOT PROJECTS; SEPSIS;

EID: 84925013831     PISSN: 01486071     EISSN: 19412444     Source Type: Journal    
DOI: 10.1177/0148607113518945     Document Type: Article

References (73)

1. Vincent JL, Sakr Y, Sprung CL, et al. Sepsis in European intensive care units: results of the SOAP study. Crit Care Med. 2006 ; 34 (2). 344-353
2. Harrison DA, Welch CA, Eddleston JM. The epidemiology of severe sepsis in England, Wales and Northern Ireland, 1996 to 2004: secondary analysis of a high quality clinical database, the ICNARC case mix programme database. Crit Care. 2006 ; 10 (2). R42
3. Levy MM, Dellinger RP, Townsend SR, et al. The surviving sepsis campaign: results of an international guideline-based performance improvement program targeting severe sepsis. Crit Care Med. 2010 ; 38 (2). 367-374
4. Dellinger RP, Levy MM, Carlet JM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2008. Intensive Care Med. 2008 ; 34 (1). 17-60
5. Hall TC, Bilku DK, Al-Leswas D, Horst C, Dennison AR. The difficulties of clinical trials evaluating therapeutic agents in patients with severe sepsis. Ir J Med Sci. 2012 ; 181 (1). 1-6
6. Lanza-Jacoby S, Flynn JT, Miller S. Parenteral supplementation with a fish-oil emulsion prolongs survival and improves rat lymphocyte function during sepsis. Nutrition. 2001 ; 17 (2). 112-116
7. Sane S, Baba M, Kusano C, et al. Eicosapentaenoic acid reduces pulmonary edema in endotoxemic rats. J Surg Res. 2000 ; 93 (1). 21-27
8. Teo TC, Selleck KM, Wan JM, et al. Long-term feeding with structured lipid composed of medium-chain and N-3 fatty acids ameliorates endotoxic shock in guinea pigs. Metabolism. 1991 ; 40 (11). 1152-1159
9. Calder PC. Use of fish oil in parenteral nutrition: rationale and reality. Proc Nutr Soc. 2006 ; 65 (3). 264-277
10. Calder PC. Hot topics in parenteral nutrition: rationale for using new lipid emulsions in parenteral nutrition and a review of the trials performed in adults. Proc Nutr Soc. 2009 ; 68 (3). 252-260
11. Calder PC. N-3 polyunsaturated fatty acids, inflammation, and inflammatory diseases. Am J Clin Nutr. 2006 ; 83 (6). 1505S - 1519S
12. Chapkin RS, Kim W, Lupton JR, McMurray DN. Dietary docosahexaenoic and eicosapentaenoic acid: emerging mediators of inflammation. Prostaglandins Leukot Essent Fatty Acids. 2009 ; 81 (2-3). 187-191
13. Galli C, Calder PC. Effects of fat and fatty acid intake on inflammatory and immune responses: a critical review. Ann Nutr Metab. 2009 ; 55 (1-3). 123-139
14. Liang B, Wang S, Ye YJ, et al. Impact of postoperative omega-3 fatty acid-supplemented parenteral nutrition on clinical outcomes and immunomodulations in colorectal cancer patients. World J Gastroenterol. 2008 ; 14 (15). 2434-2439
15. Wachtler P, Konig W, Senkal M, Kemen M, Koller M. Influence of a total parenteral nutrition enriched with omega-3 fatty acids on leukotriene synthesis of peripheral leukocytes and systemic cytokine levels in patients with major surgery. J Trauma. 1997 ; 42 (2). 191-198
16. Wassall SR, Stillwell W. Docosahexaenoic acid domains: the ultimate non-raft membrane domain. Chem Phys Lipids. 2008 ; 153 (1). 57-63
17. Chapkin RS, Wang N, Fan YY, Lupton JR, Prior IA. Docosahexaenoic acid alters the size and distribution of cell surface microdomains. Biochim Biophys Acta. 2008 ; 1778 (2). 466-471
18. Lo CJ, Chiu KC, Fu M, Lo R, Helton S. Fish oil decreases macrophage tumor necrosis factor gene transcription by altering the NF kappa B activity. J Surg Res. 1999 ; 82 (2). 216-221
19. Novak TE, Babcock TA, Jho DH, Helton WS, Espat NJ. NF-kappa B inhibition by omega-3 fatty acids modulates LPS-stimulated macrophage TNF-alpha transcription. Am J Physiol Lung Cell Mol Physiol. 2003 ; 284 (1). L84 - L89
20. Serhan CN, Chiang N, Van Dyke TE. Resolving inflammation: dual anti-inflammatory and pro-resolution lipid mediators. Nat Rev Immunol. 2008 ; 8 (5). 349-361
21. Serhan CN, Clish CB, Brannon J, Colgan SP, Chiang N, Gronert K. Novel functional sets of lipid-derived mediators with antiinflammatory actions generated from omega-3 fatty acids via cyclooxygenase 2-nonsteroidal antiinflammatory drugs and transcellular processing. J Exp Med. 2000 ; 192 (8). 1197-1204
22. Serhan CN, Clish CB, Brannon J, Colgan SP, Gronert K, Chiang N. Anti-microinflammatory lipid signals generated from dietary N-3 fatty acids via cyclooxygenase-2 and transcellular processing: a novel mechanism for NSAID and N-3 PUFA therapeutic actions. J Physiol Pharmacol. 2000 ; 51 (4, pt 1). 643-654
23. Ariel A, Serhan CN. Resolvins and protectins in the termination program of acute inflammation. Trends Immunol. 2007 ; 28 (4). 176-183
24. Anderson M, Fritsche KL. (N-3) fatty acids and infectious disease resistance. J Nutr. 2002 ; 132 (12). 3566-3576
25. Paul KP, Leichsenring M, Pfisterer M, et al. Influence of n-6 and n-3 polyunsaturated fatty acids on the resistance to experimental tuberculosis. Metabolism. 1997 ; 46 (6). 619-624
26. Palmer AJ, Ho CK, Ajibola O, Avenell A. The role of omega-3 fatty acid supplemented parenteral nutrition in critical illness in adults: a systematic review and meta-analysis. Crit Care Med. 2013 ; 41 (1). 307-316
27. Manzanares W, Dhaliwal R, Jurewitsch B, Stapleton RD, Jeejeebhoy KN, Heyland DK. Parenteral fish oil lipid emulsions in the critically ill: a systematic review and meta-analysis. JPEN J Parenter Enteral Nutr.:
28. Bernard GR, Artigas A, Brigham KL, et al. The American-European consensus conference on ARDS: definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med. 1994 ; 149 (3). 818-824
29. Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001 ; 345 (19). 1368-1377
30. Vincent JL, Moreno R, Takala J, et al. The SOFA (Sepsis-Related Organ Failure Assessment) score to describe organ dysfunction/failure: on behalf of the working group on sepsis-related problems of the European Society of Intensive Care Medicine. Intensive Care Med. 1996 ; 22 (7). 707-710
31. Vosylius S, Sipylaite J, Ivaskevicius J. Sequential Organ Failure Assessment score as the determinant of outcome for patients with severe sepsis. Croat Med J. 2004 ; 45 (6). 715-720
32. Moreno R, Vincent JL, Matos R, et al. The use of maximum SOFA score to quantify organ dysfunction/failure in intensive care: results of a prospective, multicentre study. Working Group on Sepsis Related Problems of the ESICM. Intensive Care Med. 1999 ; 25 (7). 686-696
33. Moreno R, Sprung CL, Annane D, et al. Time course of organ failure in patients with septic shock treated with hydrocortisone: results of the Corticus study. Intensive Care Med. 2011 ; 37 (11). 1765-1772
34. Pontes-Arruda A, Demichele S, Seth A, Singer P. The use of an inflammation-modulating diet in patients with acute lung injury or acute respiratory distress syndrome: a meta-analysis of outcome data. JPEN J Parenter Enteral Nutr. 2008 ; 32 (6). 596-605
35. Cohen MG, Rossi JS, Garbarino J, et al. Insights into the inhibition of platelet activation by omega-3 polyunsaturated fatty acids: beyond aspirin and clopidogrel. Thromb Res. 2011 ; 128 (4). 335-340
36. Mori TA, Beilin LJ, Burke V, Morris J, Ritchie J. Interactions between dietary fat, fish, and fish oils and their effects on platelet function in men at risk of cardiovascular disease. Arterioscler Thromb Vasc Biol. 1997 ; 17 (2). 279-286
37. Kristensen SD, Iversen AM, Schmidt EB. N-3 polyunsaturated fatty acids and coronary thrombosis. Lipids. 2001 ; 36: S79 - S82
38. Defilippis AP, Blaha MJ, Jacobson TA. Omega-3 fatty acids for cardiovascular disease prevention. Curr Treat Options Cardiovasc Med. 2010 ; 12 (4). 365-380
39. Watson PD, Joy PS, Nkonde C, Hessen SE, Karalis DG. Comparison of bleeding complications with omega-3 fatty acids + aspirin + clopidogrel-versus-aspirin + clopidogrel in patients with cardiovascular disease. Am J Cardiol. 2009 ; 104 (8). 1052-1054
40. Brun-Buisson C, Roudot-Thoraval F, Girou E, Grenier-Sennelier C, Durand-Zaleski I. The costs of septic syndromes in the intensive care unit and influence of hospital-acquired sepsis. Intensive Care Med. 2003 ; 29 (9). 1464-1471
41. Ferreira FL, Bota DP, Bross A, Melot C, Vincent JL. Serial evaluation of the SOFA score to predict outcome in critically ill patients. JAMA. 2001 ; 286 (14). 1754-1758
42. Rangel-Huerta OD, Aguilera CM, Mesa MD, Gil A. Omega-3 long-chain polyunsaturated fatty acids supplementation on inflammatory biomakers: a systematic review of randomised clinical trials. Br J Nutr. 2012 ; 107: S159 - S170
43. Barbosa VM, Miles EA, Calhau C, Lafuente E, Calder PC. Effects of a fish oil containing lipid emulsion on plasma phospholipid fatty acids, inflammatory markers, and clinical outcomes in septic patients: a randomized, controlled clinical trial. Crit Care. 2010 ; 14 (1). R5
44. Mayer K, Gokorsch S, Fegbeutel C, et al. Parenteral nutrition with fish oil modulates cytokine response in patients with sepsis. Am J Respir Crit Care Med. 2003 ; 167 (10). 1321-1328
45. Mayer K, Fegbeutel C, Hattar K, et al. Omega-3 vs. omega-6 lipid emulsions exert differential influence on neutrophils in septic shock patients: impact on plasma fatty acids and lipid mediator generation. Intensive Care Med. 2003 ; 29 (9). 1472-1481
46. Sungurtekin H, Degirmenci S, Sungurtekin U, Oguz BE, Sabir N, Kaptanoglu B. Comparison of the effects of different intravenous fat emulsions in patients with systemic inflammatory response syndrome and sepsis. Nutr Clin Pract. 2011 ; 26 (6). 665-671
47. Friesecke S, Lotze C, Kohler J, Heinrich A, Felix SB, Abel P. Fish oil supplementation in the parenteral nutrition of critically ill medical patients: a randomised controlled trial. Intensive Care Med. 2008 ; 34 (8). 1411-1420
48. Khor BS, Liaw SJ, Shih HC, Wang LS. Randomized, double blind, placebo-controlled trial of fish-oil-based lipid emulsion infusion for treatment of critically ill patients with severe sepsis. Asian J Surg. 2011 ; 34 (1). 1-10
49. Grau-Carmona T, Moran-Garcia V, Garcia-de-Lorenzo A, et al. Effect of an enteral diet enriched with eicosapentaenoic acid, gamma-linolenic acid and anti-oxidants on the outcome of mechanically ventilated, critically ill, septic patients. Clin Nutr. 2011 ; 30 (5). 578-584
50. Pontes-Arruda A, Martins LF, de Lima SM, et al. Enteral nutrition with eicosapentaenoic acid, gamma-linolenic acid and antioxidants in the early treatment of sepsis: results from a multicenter, prospective, randomized, double-blinded, controlled study: the INTERSEPT study. Crit Care. 2011 ; 15 (3). R144
51. Pontes-Arruda A, Aragao AM, Albuquerque JD. Effects of enteral feeding with eicosapentaenoic acid, gamma-linolenic acid, and antioxidants in mechanically ventilated patients with severe sepsis and septic shock. Crit Care Med. 2006 ; 34 (9). 2325-2333
52. Bowden RG, Wilson RL, Deike E, Gentile M. Fish oil supplementation lowers C-reactive protein levels independent of triglyceride reduction in patients with end-stage renal disease. Nutr Clin Pract. 2009 ; 24 (4). 508-512
53. Wohlmuth C, Dunser MW, Wurzinger B, et al. Early fish oil supplementation and organ failure in patients with septic shock from abdominal infections: a propensity-matched cohort study. JPEN J Parenter Enteral Nutr. 2010 ; 34 (4). 431-437
54. Kris-Etherton PM, Harris WS, Appel LJ. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Arterioscler Thromb Vasc Biol. 2003 ; 23 (2). e20 - e30
55. Perunicic-Pekovic GB, Rasic ZR, Pljesa SI, et al. Effect of n-3 fatty acids on nutritional status and inflammatory markers in haemodialysis patients. Nephrology (Carlton). 2007 ; 12 (4). 331-336
56. Marik PE, Zaloga GP. Immunonutrition in critically ill patients: a systematic review and analysis of the literature. Intensive Care Med. 2008 ; 34 (11). 1980-1990
57. Marik PE, Zaloga GP. Immunonutrition in high-risk surgical patients: a systematic review and analysis of the literature. JPEN J Parenter Enteral Nutr. 2010 ; 34 (4). 378-386
58. Heyland DK, Dhaliwal R, Drover JW, Gramlich L, Dodek P. Canadian clinical practice guidelines for nutrition support in mechanically ventilated, critically ill adult patients. JPEN J Parenter Enteral Nutr. 2003 ; 27 (5). 355-373
59. Rice TW, Wheeler AP, Thompson BT, et al. Enteral omega-3 fatty acid, gamma-linolenic acid, and antioxidant supplementation in acute lung injury. JAMA. 2011 ; 306 (14). 1574-1581
60. Heller AR, Rossler S, Litz RJ, et al. Omega-3 fatty acids improve the diagnosis-related clinical outcome. Crit Care Med. 2006 ; 34 (4). 972-979
61. Heller AR, Mayer K, Heyland DK. Fish oil in sepsis: if you want to catch more fish, use more hooks. JPEN J Parenter Enteral Nutr. 2011 ; 35 (2). 154-157
62. Suchner U, Katz DP, Furst P, et al. Effects of intravenous fat emulsions on lung function in patients with acute respiratory distress syndrome or sepsis. Crit Care Med. 2001 ; 29 (8). 1569-1574
63. Lekka ME, Liokatis S, Nathanail C, Galani V, Nakos G. The impact of intravenous fat emulsion administration in acute lung injury. Am J Respir Crit Care Med. 2004 ; 169 (5). 638-644
64. Burr ML, Fehily AM, Gilbert JF, et al. Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: Diet and Reinfarction Trial (DART). Lancet. 1989 ; 2 (8666). 757-761
65. Siscovick DS, Raghunathan TE, King I, et al. Dietary intake and cell membrane levels of long-chain n-3 polyunsaturated fatty acids and the risk of primary cardiac arrest. JAMA. 1995 ; 274 (17). 1363-1367
66. Mozaffarian D, Lemaitre RN, Kuller LH, et al. Cardiac benefits of fish consumption may depend on the type of fish meal consumed: the Cardiovascular Health Study. Circulation. 2003 ; 107 (10). 1372-1377
67. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-prevenzione trial. Gruppo Italiano per Lo Studio della Sopravvivenza nell'Infarto miocardico. Lancet. 1999 ; 354 (9177). 447-455
68. Kotwal S, Jun M, Sullivan D, Perkovic V, Neal B. Omega 3 fatty acids and cardiovascular outcomes: systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2012 ; 5 (6). 808-818
69. London B, Albert C, Anderson ME, et al. Omega-3 fatty acids and cardiac arrhythmias: prior studies and recommendations for future research: a report from the National Heart, Lung, and Blood Institute and Office of Dietary Supplements Omega-3 Fatty Acids and Their Role in Cardiac Arrhythmogenesis Workshop. Circulation. 2007 ; 116 (10). e320 - e335
70. Leaf A, Kang JX, Xiao YF, Billman GE. Clinical prevention of sudden cardiac death by n-3 polyunsaturated fatty acids and mechanism of prevention of arrhythmias by n-3 fish oils. Circulation. 2003 ; 107 (21). 2646-2652
71. de Kruif MD, Lemaire LC, Giebelen IA, et al. Prednisolone dose-dependently influences inflammation and coagulation during human endotoxemia. J Immunol. 2007 ; 178 (3). 1845-1851
72. Annane D, Bellissant E, Bollaert PE, et al. Corticosteroids in the treatment of severe sepsis and septic shock in adults: a systematic review. JAMA. 2009 ; 301 (22). 2362-2375
73. Pluess TT, Hayoz D, Berger MM, et al. Intravenous fish oil blunts the physiological response to endotoxin in healthy subjects. Intensive Care Med. 2007 ; 33 (5). 789-797