A randomised study on the clinical progress of high-risk elective major gastrointestinal surgery patients treated with olive oil-based parenteral nutrition with or without a fish oil supplement

• Published in: British journal of nutrition Vol. 104; no. 5; pp. 737 - 741
• Main Authors: Badía-Tahull, María B., Llop-Talaverón, Josep M., Leiva-Badosa, Elisabet, Biondo, Sebastiano, Farran-Teixidó, Leandre, Ramón-Torrell, Josep M., Jódar-Masanes, Ramón
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 14.09.2010
• Subjects: Adult; adverse effects; Aged; Aged, 80 and over; Agents antiinfecciosos; Alimentació parenteral; Anti-infective agents; Anti-Infective Agents - pharmacology; Anti-Infective Agents - therapeutic use; anti-inflammatory activity; Biological and medical sciences; C-reactive protein; carbohydrate metabolism; Cirurgia; Comparative studies; Cura postoperatòria; digestive system diseases; Double-Blind Method; Elective Surgical Procedures; Emulsions; Fat Emulsions, Intravenous - administration & dosage; Fatty acids; Feeding. Feeding behavior; Female; Fish oil; Fish oils; Fish Oils - pharmacology; Fish Oils - therapeutic use; Fundamental and applied biological sciences. Psychology; Gastrointestinal surgery; Gastrointestinal system diseases; Gastrointestinal Tract - surgery; hospitals; Human and Clinical Nutrition; Humans; Incidence; Infection; Infection - epidemiology; Infection - etiology; inflammation; Inflammatory diseases; leukocytes; lipid metabolism; liver function; Malalties del tracte gastrointestinal; Male; Middle Aged; mortality; Nutrition; Olis de peix; Olive Oil; Parenteral feeding; Parenteral Nutrition; patients; Plant Oils - administration & dosage; Postoperative care; postoperative complications; Postoperative Complications - epidemiology; Postoperative Complications - prevention & control; prealbumin; Prevention programs; Programes de prevenció; Prospective Studies; renal function; Safety; sepsis (infection); Statistical analysis; Surgery; Therapeutic use; Total parenteral nutrition; Treatment Outcome; triacylglycerols; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Ús terapèutic; Infection; Olive oil; Gastrointestinal surgery; Fish oil; Total parenteral nutrition; Human; High risk; Gastrointestinal; Parenteral administration; Symptomatology; Vertebrata; Mammalia; Surgery
• ISSN: 0007-1145; 1475-2662
• DOI: 10.1017/S0007114510001066

n-3 Fatty acids have clinical benefits. The primary aim of the present study was the assessment of infection in patients who underwent major high-risk elective gastrointestinal surgery receiving postoperatively fish oil (FO)-supplemented parenteral nutrition (PN), compared with those receiving a standard olive oil (OO) emulsion. The secondary aims were the assessment of anti-inflammatory response and evaluation of tolerance and safety of these emulsions. A prospective, randomised, double-blind study was performed in patients requiring at least 5 d of PN. An isoenergetic and isoproteic formula was administered: group A received OO alone, while group B received OO that was partially replaced with FO (16·6 %, w/w). End points were outcome measures (mortality, sepsis, infection, hospitalisation days and PN duration), inflammatory response (C-reactive protein (CRP), prealbumin and leucocytes) and safety (TAG and glucose metabolism, and liver and kidney function). Statistical analysis was done using Student's t test and Fisher's exact test (P < 0·05). Twenty-seven patients were evaluated, with thirteen patients receiving FO. In this group, a significantly lower incidence of infections was found (23·1 v. 78·6 %, P = 0·007). CRP, prealbumin and leucocytes were not significantly different between the groups. There were no differences in safety parameters. We conclude that high-risk surgical patients receiving FO-supplemented PN for 5 d present a lower incidence of infection. Emulsions were safe and well tolerated.