Supplemental intravenous n-3 fatty acids and n-3 fatty acid status and outcome in critically ill elderly patients in the ICU receiving enteral nutrition

Barros, Karina V.; Cassulino, Ana Paula; Schalch, Lívia; Munhoz, Eduardo Della Valle; Manetta, José Antônio; Noakes, Paul S.; Miles, Elizabeth A.; Calder, Philip C.; Silveira, Vera Lúcia Flor

doi:10.1016/j.clnu.2012.10.016

Cited by 24 publications

(21 citation statements)

References 30 publications

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“…The current study suggests that short‐term IV FLE in critically ill patients receiving EN could be used as a strategy to produce a less inflammatory environment, with no identified side effects. We previously reported that this strategy of IV FLE in patients receiving standard EN support modifies their fatty acid status, which appears to influence gas exchange and risk of mortality 39 . The IV FLE increased EPA, DHA, and total ω‐3 FA in plasma phosphatidylcholine and decreased the ω‐6 to ω‐3 PUFA and arachidonic acid to EPA ratios 39 …”

Section: Discussionmentioning

confidence: 99%

“…Given that the exacerbated inflammatory response in critically ill patients is a major complication related to morbidity and mortality in the ICU 37 , 38 and that ω‐3 PUFAs can control inflammation associated with rapid incorporation of these FAs into cell membranes when administered intravenously, the aim of this study was to evaluate the effect of a short‐term course of IV FLE administration associated with standard EN on nutrition intake, clinical parameters, and circulating cytokines in elderly patients in the ICU. We previously reported that these patients have higher EPA, DHA, and total ω‐3 PUFAs in plasma at the end of the study period and that a higher ω‐3 PUFA status is associated with better gas exchange and improved survival 39 …”

Section: Introductionmentioning

confidence: 89%

“…Thus, full data were available for 40 patients, 25 in the control group and 15 in the FLE group. Both groups include patients for whom data on FA status, gas exchange, and clinical outcomes were reported previously 39 …”

Section: Methodsmentioning

confidence: 99%

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Pharmaconutrition

Barros

Cassulino

Schalch

et al. 2013

J Parenter Enteral Nutr

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 89%

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Pharmaconutrition

Barros

Cassulino

Schalch

et al. 2013

J Parenter Enteral Nutr

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“…Initial screening resulted in 23 candidate studies (24 articles, with two belonging to one study) [11,12,13,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44]. Figure 1 shows the details of the selection process and the reasons for exclusion.…”

Section: Resultsmentioning

confidence: 99%

Is Omega-3 Fatty Acids Enriched Nutrition Support Safe for Critical Ill Patients? A Systematic Review and Meta-Analysis

et al. 2014

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Objective: To systematically review the effects of omega-3 poly unsaturated fatty acids (FA) enriched nutrition support on the mortality of critically illness patients. Methods: Databases of Medline, ISI, Cochrane Library, and Chinese Biomedicine Database were searched and randomized controlled trials (RCTs) were identified. We enrolled RCTs that compared fish oil enriched nutrition support and standard nutrition support. Major outcome is mortality. Methodological quality assessment was conducted based on Modified Jadad’s score scale. For control heterogeneity, we developed a method that integrated I2 test, nutritional support route subgroup analysis and clinical condition of severity. RevMan 5.0 software (The Nordic Cochrane Centre, Copenhagen, Denmark) was used for meta-analysis. Results: Twelve trials involving 1208 patients that met all the inclusion criteria. Heterogeneity existed between the trials. A random model was used, there was no significant effect on mortality RR, 0.82, 95% confidence interval (CI) (0.62, 1.09), p = 0.18. Knowing that the route of fish oil administration may affect heterogeneity, we categorized the trials into two sub-groups: parenteral administration (PN) of omega-3 and enteral administration (EN) of omega-3. Six trials administered omega-3 FA through PN. Pooled results indicated that omega-3 FA had no significant effect on mortality, RR 0.76, 95% CI (0.52, 1.10), p = 0.15. Six trials used omega-3 fatty acids enriched EN. After excluded one trial that was identified as source of heterogeneity, pooled data indicated omega-3 FA enriched EN significant reduce mortality, RR=0.69, 95% CI [0.53, 0.91] (p = 0.007). Conclusion: Omega-3 FA enriched nutrition support is safe. Due to the limited sample size of the included trials, further large-scale RCTs are needed.

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“…Supplies of immunonutrition can promote the postoperative maintenance of homeostasis and limit undesired immune and inflammatory reactions [8][9][10]. Like standard nutritional support, immunonutrition can be given enterally and parentally.…”

Section: Introductionmentioning

confidence: 99%

Effects of Enteral Immunonutrition in Patients Undergoing Pancreaticoduodenectomy: A Meta-Analysis of Randomized Controlled Trials

Guan

Chen

Huang³

2018

Ann Nutr Metab

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Background: The effect of enteral immunonutrition (EIN) in patients undergoing pancreaticoduodenectomy (PD) is still doubtful. This meta-analysis aimed to assess the impact of EIN on postoperative clinical outcomes for patients undergoing PD. Methods: A literature search was carried out to identify all of the randomized controlled trials (RCTs) concerning the use of EIN for PD. Data collection ended on April 1, 2018. Pooled risk ratios (RRs) and the mean difference (MD) with a 95% CI were calculated using fixed effects or random effects models. The analyses were performed with RevMan 5.3.5. Results: Four RCTs with a total of 299 patients were included. Immunonutrition reduced the incidence of postoperative infectious complications (RR 0.58, 95% CI 0.37–0.92; p = 0.02) and shortened the length of hospital stay (MD –1.79, 95% CI –3.40 to 0.18; p = 0.03). Conversely, there were no significant differences in the incidence of overall postoperative complications (RR 0.81, 95% CI 0.62–1.05; p = 0.11), non-infectious complications (RR 0.94, 95% CI 0.69–1.28; p = 0.70) and postoperative mortality (RR 2.43, 95% CI 0.37–16.10; p = 0.36). Conclusions: EIN reduced postoperative infectious complications and shortened the length of the hospital stay; immunonutrition should be encouraged in patients undergoing PD.

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Supplemental intravenous n-3 fatty acids and n-3 fatty acid status and outcome in critically ill elderly patients in the ICU receiving enteral nutrition

Cited by 24 publications

References 30 publications

Pharmaconutrition

Pharmaconutrition

Is Omega-3 Fatty Acids Enriched Nutrition Support Safe for Critical Ill Patients? A Systematic Review and Meta-Analysis

Effects of Enteral Immunonutrition in Patients Undergoing Pancreaticoduodenectomy: A Meta-Analysis of Randomized Controlled Trials

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