Enhanced survival to endotoxin in guinea pigs fed IV fish oil emulsion

2003

Braz J Med Biol Res

157

120

Section: Fish Oil and Animal Models Of Endotoxemia And Sepsismentioning

confidence: 99%

Long-chain n-3 fatty acids and inflammation: potential application in surgical and trauma patients

2003

Braz J Med Biol Res

157

120

“…Thus, using fish oil to partly replace soyabean oil in parenteral nutrition offers the possibility to both decrease the amount of linoleic acid present and increase the amount of biologically active n-3 PUFA. Animal feeding studies have demonstrated that fish oil decreases the production of inflammatory eicosanoids and cytokines in endotoxaemia (42)(43)(44) or sepsis (45)(46)(47) and that this is associated with a decreased metabolic response (48)(49)(50)(51) , improved organ function (43,(52)(53)(54)(55)(56)(57) and improved survival (45)(46)(47)(58)(59)(60) .…”

Section: Desirable Properties For Lipids To Be Used In Artificial Nutmentioning

confidence: 99%

Rationale and use of n-3 fatty acids in artificial nutrition

2010

Proc. Nutr. Soc.

Lipids traditionally used in artificial nutrition are based on n-6 fatty acid-rich vegetable oils like soyabean oil. This may not be optimal because it may present an excessive supply of linoleic acid. One alternative to the use of soyabean oil is its partial replacement by fish oil, which contains n-3 fatty acids. These fatty acids influence inflammatory and immune responses and so may be useful in particular situations where those responses are not optimal. Fish oil-containing lipid emulsions have been used in parenteral nutrition in adult patients post-surgery (mainly gastrointestinal). This has been associated with alterations in patterns of inflammatory mediators and in immune function and, in some studies, a reduction in length of intensive care unit (ICU) and hospital stay. Perioperative administration of fish oil may be superior to post-operative. Parenteral fish oil has been used in critically ill adults. Here the influence on inflammatory processes, immune function and clinical endpoints is not clear, since there are too few studies and those that are available report contradictory findings. Fish oil is included in combination with other nutrients in various enteral formulas. In post-surgical patients and in those with mild sepsis or trauma, there is clinical benefit from a formula including fish oil and arginine. A formula including fish oil, borage oil and antioxidants has demonstrated marked benefits on gas exchange, ventilation requirement, new organ failures, ICU stay and mortality in patients with acute respiratory distress syndrome, acute lung injury or severe sepsis.

“…The benefits of fish oil in animal models of experimental endotoxaemia have been clearly demonstrated. For example, dietary fish oil or fish oil infused intravenously markedly enhances the survival of guineapigs to intraperitoneal endotoxin when compared with safflower oil (Mascioli et al 1988(Mascioli et al , 1989. Also, dietary fish oil results in a decreased concentration of circulating post-endotoxin eicosanoids (PGE 2 , TXB 2 , 6-keto-PGF 1a in rats and in decreased eicosanoid generation by alveolar macrophages (Utsunomiya et al 1994;Sane et al 2000).…”

Section: Fish Oil Inflammation and Immunitymentioning

confidence: 99%

Use of fish oil in parenteral nutrition: rationale and reality

2006

Proc. Nutr. Soc.

Excessive or inappropriate inflammation and immunosuppression are components of the response to surgery, trauma, injury and infection in some individuals and can lead, progressively, to sepsis and septic shock. The hyperinflammation is characterised by the production of inflammatory cytokines, arachidonic acid-derived eicosanoids and other inflammatory mediators, while the immunosuppression is characterised by impairment of antigen presentation and of T-helper lymphocyte type-1 responses. Long-chain n-3 fatty acids from fish oil decrease the production of inflammatory cytokines and eicosanoids. They act both directly (by replacing arachidonic acid as an eicosanoid substrate and by inhibiting arachidonic acid metabolism) and indirectly (by altering the expression of inflammatory genes through effects on transcription factor activation). Thus, long-chain n-3 fatty acids are potentially useful anti-inflammatory agents and may be of benefit in patients at risk of hyperinflammation and sepsis. As a consequence, an emerging application for n-3 fatty acids, in which they may be added to parenteral (or enteral) formulas, is in surgical or critically-ill patients. Parenteral nutrition that includes n-3 fatty acids appears to preserve immune function better than standard formulas and appears to diminish the extent of the inflammatory response. Studies to date are suggestive of clinical benefits from these approaches, especially in patients post surgery, although evidence of clinical benefit in patients with sepsis is emerging.