Safety and Efficacy of Fish Oil–Enriched Parenteral Nutrition Regimen on Postoperative Patients Undergoing Major Abdominal Surgery

Chen, Bo; Zhou, Yong; Yang, Ping; Wan, Hang; Wu, Xiaoting

doi:10.1177/0148607110362532

Cited by 110 publications

(107 citation statements)

References 53 publications

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“…Administration of n-3 long-chain polyunsaturated fatty acids (LC-PUFAs), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) to adults who undergo surgical trauma has resulted in decreased inflammatory cytokines [7], reduced risk of developing infections and shorter stays in intensive care unit (ICU) [9]. Such possible beneficial effects have been scarcely investigated in neonates who present a high susceptibility and risk of death; therefore, it is relevant to evaluate new strategies to improve their clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

Beneficial Effects of Enteral Docosahexaenoic Acid on the Markers of Inflammation and Clinical Outcomes of Neonates Undergoing Cardiovascular Surgery: An Intervention Study

Bernabe‐García¹,

López-Alarcón²,

Villegas-Silva

et al. 2016

Ann Nutr Metab

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Background: Neonates undergoing surgery are at risk for uncontrolled inflammatory response and adverse clinical outcomes. Docosahexaenoic acid (DHA) ameliorates inflammation, improving clinical outcomes. However, its effect has not been evaluated in neonates undergoing surgery. We evaluated the effect of DHA on markers of inflammation and clinical outcomes in neonates undergoing surgery. Methods: A double-blind clinical trial evaluated the effect of enteral DHA (DHA group) versus sunflower oil (SO group) perioperatively administered in neonates scheduled for cardiovascular surgery. Inflammation was evaluated by percentage of cells⁺ for cytokines and CD69 in mononuclear cells at baseline, 24 h and 7 days post surgery. Clinical outcomes measured were sepsis, organ dysfunctions (ODs), length of stay in intensive care and bleeding. Repeated measures analysis of variance and logistic regression were applied. Results: Sixteen neonates received DHA and 18 received SO. Cells⁺ from neonates in the DHA group showed an early increase in receptor antagonist of interleukin (IL)-1⁺ (IL-1ra⁺) and IL-10⁺ and a late decrease in IL-6⁺. IL-1β⁺ and IL-10⁺ changes were different between groups. After adjusting for confounders, less cells from DHA group were IL-1β⁺, IL-6⁺, IL-1ra⁺ and IL-10⁺. DHA group presented less sepsis, ODs and shorter stay, but no difference in CD69⁺CD4⁺ cells or bleeding between groups. Conclusions: Administration of enteral DHA ameliorates markers of inflammation and improves clinical outcomes in surgical neonates.

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Section: Introductionmentioning

confidence: 99%

Beneficial Effects of Enteral Docosahexaenoic Acid on the Markers of Inflammation and Clinical Outcomes of Neonates Undergoing Cardiovascular Surgery: An Intervention Study

Bernabe‐García¹,

López-Alarcón²,

Villegas-Silva

et al. 2016

Ann Nutr Metab

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“…The current review pooled data from 17 studies and showed like Chen et al [17] a significant reduction in the infection complications rate, HLOS and ICU stay, liver profile (AST), and lipid fatty acid patterns (increase of EPA and DHA) when PN was enriched with FO. In our study, further improvement was noted in the results of immune function (CD 4+ /CD 8+ ) and inflammatory response (decrease of IL-6 and TNF-α).…”

Section: Discussionmentioning

confidence: 87%

“…However, there are studies demonstrating that administration of FO (0.2 g/kg per day) after surgical stress is not immunosuppressive, but increases production of IFN-γ, TNF-α, and IL-2 [16]. Previous meta-analysis demonstrated that parenteral nutrition enriched with FO have proven to be well tolerated, in terms of clinical and metabolic outcomes [17][18][19]. However, the studies included in these meta-analyses are very heterogeneous in their interventions and subjects.…”

Section: Introductionmentioning

confidence: 99%

Parenteral Nutrition Enriched with Fish Oil after Gastrointestinal Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Kim¹,

Shin²,

Choi³

2016

Int J Clin Pharmacol Pharmacother

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Objective: We performed a systematic review and meta-analysis to assesses the effects of parenteral nutrition enriched with fish oil versus without fish oil after gastrointestinal surgery. Methods: A search was conducted on Medline, Embase and the Cochrane Library electronic databases. Results: After the review of 17 trials, parenteral nutrition enriched with fish oil improved the infection complications rate (risk ratio (RR) = 0.43; 95% CI: 0.28 to 0.67), length of hospital stay (mean difference (MD) = -1.69; 95% CI: -2, 72 to -0.66) and length of intensive care unit stay (MD = -0.33; 95% CI: -0.51 to -0.14). Other beneficial effects included improvement of liver function AST (MD = -18.25; 95% CI,-30.10 to -6.41), immune function CD 4+ /CD 8+ (MD = 0.16; 95% CI: 0.01 to 0.31), reduction of inflammation markers IL-6 (MD = -7.03; 95% CI: -11.10 to -2.97) and TNF-a (MD = -1.18; 95% CI: -1.71 to -0.66), and increased concentrations of EPA (standard mean difference (SMD) = 5.41; 95% CI: 2.47 to 8.34) and DHA (SMD = 3.20; 95% CI: 1.27 to 5.14). Conclusion: Through these results, we conclude that parenteral nutrition enriched with fish oil is safe and effective. However, further studies in larger patient populations with more extensive investigation are needed to reassess the role of FO.

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“…Unsaturated fatty acids as precursors of prostaglandins, are important components of cell membranes, which maintain the fluidity of cell membranes, and participate in the regulation of cellular and biochemical responses [7]. Fish oil/kg body weight/day (0.2 g) in addition to TPN has been recommended to be taken by gastrointestinal tumor patients after surgery, for reduction of inflammatory response syndrome and post-operative recovery, on the basis of the fact that ω-3 unsaturated fatty acids inhibit the formation of pro-inflammatory factors (IL-6 and TNF-a), increase the synthesis of antiinflammatory factor IL-10, improve immune function and eliminate excessive inflammation [8,9].…”

Section: Discussionmentioning

confidence: 99%

Effects of parenteral nutrition of ω-3 polyunsaturated fatty acid, arginine and glutamine on cellular immune status of patients following liver cancer surgery

Guo¹,

Ge²,

Han³

et al. 2018

Trop. J. Pharm Res

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Purpose: To study the effects of parenteral nutrition (TPN), ω-3 polyunsaturated fatty acid (PUFA), Larginine (Arg), and glutamine on cellular immunity of patients who 05). IL-6 in group E was lower than that in any of the other four groups (p < 0.05). IL-10 in group A was lower than that in groups B, C and D, but lower than in group E (p < 0.05). The levels of TNF-a in groups B and C were lower than those in group A, but higher than that in group E (p < 0.05) but lower than in group D. IgA in group E was higher than in the other groups (p < 0.05), while IgM level in group E was lower than in groups A, B and C (p < 0.05

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Safety and Efficacy of Fish Oil–Enriched Parenteral Nutrition Regimen on Postoperative Patients Undergoing Major Abdominal Surgery

Abstract: Based on the meta-analysis, fish oil-supplemented parenteral nutrition was safe, improved clinical outcomes, and altered the fatty acid pattern as well as leukotriene synthesis. More laboratory parameters should be considered in future meta-analyses.

Cited by 110 publications

References 53 publications

Beneficial Effects of Enteral Docosahexaenoic Acid on the Markers of Inflammation and Clinical Outcomes of Neonates Undergoing Cardiovascular Surgery: An Intervention Study

Beneficial Effects of Enteral Docosahexaenoic Acid on the Markers of Inflammation and Clinical Outcomes of Neonates Undergoing Cardiovascular Surgery: An Intervention Study

Parenteral Nutrition Enriched with Fish Oil after Gastrointestinal Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Effects of parenteral nutrition of ω-3 polyunsaturated fatty acid, arginine and glutamine on cellular immune status of patients following liver cancer surgery

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