Effect of pretreatment with omega-3 polyunsaturated fatty acids (PUFAs) on hematological parameters and platelets aggregation in patients during elective coronary artery bypass grafting

Abstract

This prospective, randomized, placebo-controlled, single-center trial was performed on parallel groups. The patients (n = 40) undergoing elective CABG were randomized receivin preoperative intravenous omega-3 PUFAs (Omegaven 10%) infusion (the PUFAs group) or the same volume of 0.9% saline solution infusion (the control group). Infusion was given a day before surgery and repeated four hours before starting extracorporeal circulation (CPB) via the pe ripheral vein at single doses of 100 mL (25 mL/h). Platelet function analysis was performed using multiple electrode aggregometry (MEA, multiplate-analyzer) before starting CPB and 2 h postoperatively for the patients of both groups. Results. There were no clinically relevant differ ences in baseline characteristics between the groups. He matological parameters were not significantly different between the groups pre-, intra- and postoperatively. Dur ing the first 24 h after surgery, the loss of blood was simi lar in the PUFAs and the control group (680 +/- 274 mL and 608 +/- 210 mL, respectively; p = 0.356). Postopera tively, platelet aggregation was not significantly different between the PUFAs and the control group in adenosine diphosphate (ADP) test (39 +/- 11 and 42 +/- 15, respec tively; p = 0.701), arachidonic acid (ASPI) test (64 +/- 24 and 70 +/- 27, respectively; p = 0.525) and trombin receptor-activating peptide (TRAP) test (68 +/- 25 and 75 + 26, respectively; p = 0.396), while their aggregation in collagen (COL) test was statistically significantly lower in the PUFAs related to the control group (32 +/- 15 and 47 +/- 20, re spectively; p = 0.009). Conclusion. Acute pretreatment with omega-3 PUFAs insignificantly affected the activity of platelets and did not influence postoperative blood loss.

Dose-response effects of omega-3 on platelet aggregation: an observational study

“…Fish oil has been shown to reduce stimulated platelet aggregation and increase bleeding time. 12,13 In a recent study, Gong et al. 14 showed that omega-3 fatty acids in combination with low-dose aspirin led to a significant reduction in platelet aggregation as measured with Born aggregometry in a mouse model.…”

Effects of naturopathic medicines on Multiplate and ROTEM: a prospective experimental pilot study in healthy volunteers

“…Furthermore, fish oil has been shown to reduce ADP-, adrenaline- and COL-induced platelet aggregation as well as P-selectin expression and to increase bleeding time [ 20 ]. Veljovic et al [ 19 ] studied intravenous administration of 2100 mg Ω-3 polyunsaturated fatty acids 1 day and 4 h prior to coronary bypass surgery in a prospective randomized controlled trial. Compared to controls, Ω-3 polyunsaturated fatty acids significantly reduced postoperative platelet aggregation measured with Multiplate COL assay.…”

“…Neither ROTEM nor TEG has been used to monitor naturopathic medicines. Fish oil has been shown to reduce platelet collagen receptor function, as detected by the Multiplate COL [ 19 ] and ADP tests [ 11 ]. A review article mentions reduction of thromboxane A2 levels as a possible mechanism of garlic and fish oil [ 20 ].…”

Effects unrelated to anti-inflammation of lipid emulsions containing fish oil in parenteral nutrition for adult patients

“…The results showed no differences in international normalized ratio (INR), activated partial thromboplastin time, bleeding volume, blood transfusion or fresh frozen plasma requirements, platelet count in postoperative period, and heparin or protamine use. Only in one of four tests platelets activity was statistically lower in the FO group, but with no negative effect (50).…”