Improved fatty acid and leukotriene pattern with a novel lipid emulsion in surgical patients

Grimm, H.; Mertes, N.; Goeters, Christiane; Schlotzer, E.; Mayer, Konstantin; Grimminger, Friedrich; Fürst, Peter

doi:10.1007/s00394-005-0573-8

Cited by 153 publications

(132 citation statements)

References 37 publications

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“…05) than soyabean oil (62) . Taken together, these studies indicate that inclusion of fish oil in parenteral nutrition regimens for gastrointestinal surgical patients modulates the generation of inflammatory eicosanoids (61,62,66,67) and cytokines (4,66,68) and may help to counter the surgery-induced decline in antigen presenting cell activity (68) and T lymphocyte cytokine production (69) . Importantly, these studies do not reveal any deleterious effects of fish oil infusion in these patients.…”

Section: 5 D)mentioning

confidence: 98%

“…Intravenous infusion of lipid emulsions containing fish oil into patients following gastrointestinal surgery altered the fatty acid composition of plasma (61)(62)(63)(64) , platelet (65) and erythrocyte (64) phospholipids: typically EPA content was increased. Intravenous infusion of a lipid emulsion containing fish oil into patients for 5 d following gastrointestinal surgery also altered the fatty acid composition of leucocytes: EPA content was increased 2 .…”

Section: Studies Of Parenteral Fish Oil In Surgical Patientsmentioning

confidence: 99%

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

Calder

2010

Proc. Nutr. Soc.

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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.

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Section: 5 D)mentioning

confidence: 98%

Section: Studies Of Parenteral Fish Oil In Surgical Patientsmentioning

confidence: 99%

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

Calder

2010

Proc. Nutr. Soc.

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“…Parenteral treatment with an emulsion with reduced content of n-6 fatty acids, increased share of MUFA and n-3 FA and supplemental vitamin E is well tolerated and modulates FA and leukotriene pattern, suggesting favourable anti-inflammatory effects and further clinical benefits [7]. Fig.…”

Section: Fish Oil and Cancer Cachexiamentioning

confidence: 98%

Fish oil and treatment of cancer cachexia

Giacosa

Rondanelli

2008

Genes Nutr

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Cancer cachexia is a syndrome characterized by high prevalence and multifactorial etiology. The pathophysiology of cancer-induced weight loss is mainly due to failure of food intake and to various metabolic abnormalities, including hypermetabolism. Multiple biologic pathways are involved in this process, including proinflammatory cytokines, neuroendocrine hormones and tumour specific factors such as proteolysis inducing factor (PIF). As a result, a protein and energy depletion is observed that is greater than what would be expected based on the simple decrease of food intake and is associated with marked reduction of lean body mass (LBM). Therapy requires a multi-model approach with control of reduced food intake and of the metabolic abnormalities. Combination treatment with nutritional support and modulation of metabolic/inflammation changes is promising. In this regard, n-3 fatty acids in dose of at least 1.5 g/day for a prolonged time to advanced cancer patients with weight loss, are associated with an improvement of clinical, biological and functional parameters and with amelioration of quality of life.

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“…05) than soyabean oil (42) . Taken together, these studies indicate that inclusion of fish oil in parenteral nutrition regimens for patients who have undergone gastrointestinal surgery modulates generation of inflammatory eicosanoids (43)(44)(45)(46) and cytokines (44,47) and may help to counter the surgery-induced decline in antigen-presenting-cell activity (47) and production of T-lymphocyte cytokines (48) . Importantly, these studies do not reveal any deleterious effects of fish oil infusion in these patients.…”

Section: Studies Of Fish Oil In Patients Following Surgerymentioning

confidence: 99%

“…This outcome would be expected to impact on the profile of eicosanoids produced from arachidonic acid and EPA. Indeed, several studies have demonstrated that intravenous infusion of lipid emulsions containing fish oil into patients who had undergone major gastrointestinal surgery results in lower production of arachidonic acid-derived eicosanoids and higher production of EPA-derived eicosanoids by blood leucocytes stimulated ex vivo (43)(44)(45)(46) . Plasma TNFa concentrations are lower at day 6 post surgery while plasma IL-6 New lipid emulsions in parenteral nutrition (44) .…”

Section: Studies Of Fish Oil In Patients Following Surgerymentioning

confidence: 99%

Rationale for using new lipid emulsions in parenteral nutrition and a review of the trials performed in adults

Calder

2009

Proc. Nutr. Soc.

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Lipids traditionally used in parenteral nutrition are based on n-6 fatty acid-rich vegetable oils such as soyabean oil. This practice may not be optimal because it may present an excessive supply of linoleic acid. Alternatives to the use of soyabean oil include its partial replacement by so-called medium-chain TAG (MCT), olive oil or fish oil, either alone or in combination. Lipid emulsions containing MCT are well established, but those containing olive oil and fish oil, although commercially available, are still undergoing trials in different patient groups. Emulsions containing olive oil or fish oil are well tolerated and without adverse effects in a wide range of adult patients. An olive oil–soyabean oil emulsion has been used in quite small studies in critically-ill patients and in patients with trauma or burns with little real evidence of advantage over soyabean oil or MCT–soyabean oil. Fish oil-containing lipid emulsions have been used in adult patients post surgery (mainly gastrointestinal). This approach has been associated with alterations in patterns of inflammatory mediators and in immune function and, in some studies, a reduction in the length of stay in the intensive care unit and in hospital. One study indicates that peri-operative administration of fish oil may be superior to post-operative administration. Fish oil has been used in critically-ill adults. Here, the influence on inflammatory processes, immune function and clinical end points is not clear, since there are too few studies and those that are available report contradictory findings. One important factor is the dose of fish oil required to influence clinical outcomes. Further studies that are properly designed and adequately powered are required in order to strengthen the evidence base relating to the use of lipid emulsions that include olive oil and fish oil in critically-ill patients and in patients post surgery.

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Improved fatty acid and leukotriene pattern with a novel lipid emulsion in surgical patients

Abstract: Treatment with the new emulsion SMOFlipid is well tolerated and modulates FA and leukotriene pattern suggesting favourable anti-inflammatory effects and further clinical benefits.

Cited by 153 publications

References 37 publications

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

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

Fish oil and treatment of cancer cachexia

Rationale for using new lipid emulsions in parenteral nutrition and a review of the trials performed in adults

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