Beneficial Effects of Omega-3 Supplement to the Enteral Feeding in Children With Mild to Moderate Sepsis

Al‐Biltagi, Mohammed; Abo-Elezz, Ahmed Abd ElBasset; Abdel-Hafez, Maher; Mabrouk, Maaly M.; Suliman, Ghada Abudelmomen

doi:10.1177/0885066615623927

Cited by 16 publications

(15 citation statements)

References 34 publications

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“…This situation allowed (i) maintenance of the oxidative phosphorylation through prevention of mPTP opening, (ii) upholding of the intensity of the intermediate metabolism characterized by an increased β -oxidation rate despite an apparent reduction of glycolysis suggested by the decrease in gene expression of enzymes directly involved in the glycolytic pathway (HK2 and PKm), and (iii) a decrease in the inflammatory response characterized by a slackening of the NF- κ B pathway and reduction of IL-1 β gene expression. This underlines the cardioprotective effects of EPA on sepsis, which is well documented in the literature by numerous human studies [47–62].…”

Section: Discussionsupporting

confidence: 62%

Antioxidant and Cardioprotective Effects of EPA on Early Low-Severity Sepsis through UCP3 and SIRT3 Upholding of the Mitochondrial Redox Potential

Leger

Azarnoush

Traoré³

et al. 2019

Oxidative Medicine and Cellular Longevity

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Sepsis still causes death, often through cardiac failure and mitochondrial dysfunction. Dietary ω3 polyunsaturated fatty acids are known to protect against cardiac dysfunction and sepsis lethality. This study set out to determine whether early low-severity sepsis alters the cardiac mitochondrial function in animals fed a Western-type diet and whether dietary eicosapentaenoic acid (EPA) administration protects the myocardium against the deleterious effects of sepsis and if so to seek possible mechanisms for its effects. Rats were divided into two groups fed either an ω3 PUFA-deficient diet (“Western diet,” DEF group) or an EPA-enriched diet (EPA group) for 5 weeks. Each group was subdivided into two subgroups: sham-operated rats and rats subjected to cecal ligation and puncture (CLP). In vivo cardiac mechanical function was examined, and mitochondria were harvested to determine their functional activity. Oxidative stress was evaluated together with several factors involved in the regulation of reactive oxygen species metabolism. Sepsis had little effect on cardiac mechanical function but strongly depressed mitochondrial function in the DEF group. Conversely, dietary EPA greatly protected the mitochondria through a decreased oxidative stress of the mitochondrial matrix. The latter was probably due to an increased uncoupling protein-3 expression, already seen in the sham-operated animals. CLP rats in the EPA group also displayed increased mitochondrial sirtuin-3 protein expression that could reinforce the upholding of oxidative phosphorylation. Dietary EPA preconditioned the heart against septic damage through several modifications that protect mitochondrial integrity. This preconditioning can explain the cardioprotective effect of dietary EPA during sepsis.

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Section: Discussionsupporting

confidence: 62%

Antioxidant and Cardioprotective Effects of EPA on Early Low-Severity Sepsis through UCP3 and SIRT3 Upholding of the Mitochondrial Redox Potential

Leger

Azarnoush

Traoré³

et al. 2019

Oxidative Medicine and Cellular Longevity

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“…One RCT was terminated during interim analysis because of unlikely benefit in the intervention arm [380]. In another small RCT, use of enteral feeding supplemented with or without omega-3 fatty acids in 120 critically ill children with sepsis was investigated [381]. Univariate analyses showed a significant difference in inflammatory mediators and reduction in PICU LOS, but these outcome benefits were not evident in the multivariable analyses.…”

Section: We Suggest Against Supplementation With Specialized Lipid Emmentioning

confidence: 99%

Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children

et al. 2020

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Objectives: To develop evidence-based recommendations for clinicians caring for children (including infants, school-aged children, and adolescents) with septic shock and other sepsis-associated organ dysfunction.Design: A panel of 49 international experts, representing 12 international organizations, as well as three methodologists and three public members was convened. Panel members assembled at key international meetings (for those The Society of Critical Care Medicine guidelines are intended for general information only, are not medical advice, and do not replace professional advice, which should be sought for any medical condition. The full disclaimer for guidelines can be accessed at https ://www.sccm.org/Resea rch/Guide lines /Guide lines . panel members attending the conference), and a stand-alone meeting was held for all panel members in November 2018. A formal conflict-of-interest policy was developed at the onset of the process and enforced throughout. Teleconferences and electronic-based discussion among the chairs, co-chairs, methodologists, and group heads, as well as within subgroups, served as an integral part of the guideline development process. Methods:The panel consisted of six subgroups: recognition and management of infection, hemodynamics and resuscitation, ventilation, endocrine and metabolic therapies, adjunctive therapies, and research priorities. We conducted a systematic review for each Population, Intervention, Control, and Outcomes question to identify the best available evidence, statistically summarized the evidence, and then assessed the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach. We used the evidence-to-decision framework to formulate recommendations as strong or weak, or as a best practice statement. In addition, "in our practice" statements were included when evidence was inconclusive to issue a recommendation, but the panel felt that some guidance based on practice patterns may be appropriate. Results:The panel provided 77 statements on the management and resuscitation of children with septic shock and other sepsis-associated organ dysfunction. Overall, six were strong recommendations, 49 were weak recommendations, and nine were best-practice statements. For 13 questions, no recommendations could be made; but, for 10 of these, "in our practice" statements were provided. In addition, 52 research priorities were identified. Conclusions:A large cohort of international experts was able to achieve consensus regarding many recommendations for the best care of children with sepsis, acknowledging that most aspects of care had relatively low quality of evidence resulting in the frequent issuance of weak recommendations. Despite this challenge, these recommendations regarding the management of children with septic shock and other sepsis-associated organ dysfunction provide a foundation for consistent care to improve outcomes and inform future research. S14 the group heads, panel members, and methodologists. Searches utilized ...

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“…Moreover, LPC significantly decreased HMGB1 release from monocytes and macrophages in murine endotoxemia and sepsis [171] and reduced circulating IL-1b levels, subsequently diminishing organ injury and dysfunction [172]. Supplementation with v-3-fatty acid supplements has been shown to be beneficial on several outcome measures in sepsis patients-among others, less secondary infections and shorter ICU stay [107,173,174]. In vitro, v-3-fatty acids reduce IL-1b production by suppressing nuclear translocation of NF-kB and enhancing autophagy [175] and inhibit caspase-1 activity and subsequently, nucleotide-binding domain, leucine-rich repeatcontaining family, pyrin domain-containing 3 inflammasome activity [176].…”

Section: Fatty Acid Metabolismmentioning

confidence: 99%

Cellular metabolism of myeloid cells in sepsis

Arts

Gresnigt

Joosten

et al. 2016

Journal of Leukocyte Biology

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In recent years, it has become appreciated that immune cells have different metabolic profiles depending on their activation status. During sepsis, circulating leukocytes go through a hyperinflammatory state, which can be accompanied or followed by defective antimicrobial defenses (also described as immune tolerance or paralysis). In this review, the modulation of different cellular metabolic pathways during sepsis in monocytes and macrophages will be discussed. Glycolysis is studied extensively in sepsis and is up-regulated in hyperinflammatory cells, whereas in immune tolerance, it is often down-regulated. Few data are available on other metabolic pathways in immune cells from patients with sepsis. The pentose phosphate pathway is up-regulated during acute hyperinflammatory responses, whereas fatty acid β-oxidation is increased later during sepsis and is associated with an anti-inflammatory (M2) phenotype of macrophages. Within the amino acid metabolism we will discuss the most studied metabolites. Collectively, these data argue that exploration of the immunometabolic pathways in sepsis is an important area of research, and the targeting of metabolic pathways may represent a promising novel strategy as a therapy of sepsis.

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Beneficial Effects of Omega-3 Supplement to the Enteral Feeding in Children With Mild to Moderate Sepsis

Abstract: Children with mild to moderate sepsis showed significant improvement in inflammatory markers and had shorter PICU admission when enteral feeding was supplemented with omega-3 essential fatty acids.

Cited by 16 publications

References 34 publications

Antioxidant and Cardioprotective Effects of EPA on Early Low-Severity Sepsis through UCP3 and SIRT3 Upholding of the Mitochondrial Redox Potential

Antioxidant and Cardioprotective Effects of EPA on Early Low-Severity Sepsis through UCP3 and SIRT3 Upholding of the Mitochondrial Redox Potential

Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children

Cellular metabolism of myeloid cells in sepsis

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