Omega-3 fish oil reduces mortality due to severe sepsis with acute gastrointestinal injury grade III
Huaisheng Chen1, Wei Wang2, Chengying Hong1, Ming Zhang3, Yingcai Hong4, Su Wang5, Huadong Zhang1
1 Department of Intensive Care Unit, Shenzhen People's Hospital, The Second Clinical Hospital of Jinan University, Dong Men North Road, Luohu District, Shenzhen, China
2 Department of Endocrinology, Shenzhen People's Hospital, The Second Clinical Hospital of Jinan University, Dong Men North Road, Luohu District, Shenzhen, Guangdong, China
3 Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
4 The Chest Department of Shenzhen People's Hospital, The Second Clinical Hospital of Jinan University, Shenzhen, Guangdong, China
5 The Cardiovascular and thoracic surgery ICU, PLA 305 Hospital, Beijing, China
Department of Endocrinology, Shenzhen People's Hospital, The Second Clinical Hospital of Jinan University, No. 1017, Dongmen North Road, Luohu District, Shenzhen 518020, Guangdong
Source of Support: None, Conflict of Interest: None
Background: Sepsis plays an important role in acute gastrointestinal injury (AGI). Our research was designed to determine the effects of omega-3 fish oil (FO) in patients suffering from severe sepsis combined with AGI III, and the ability of FO to modulate immune function. Methods: Seventy-eight patients diagnosed with severe sepsis with AGI III and a need for mechanical ventilation were randomized to two groups. In the FO group, 50 g of long chain fatty acid soybean oil (n = 6) and 10 g of FO (n = 3) were administered as total parenteral nutrition (TPN). The control group was treated with 50 g of long chain fatty acid soybean oil without addition of FO to TPN. Results: At baseline, there were no significant differences between the two groups. The 60-day mortality was lower in the FO group. Multiple factor logistic regression analysis revealed that intra-abdominal pressure (IAP) and abdominal infection were correlated with the FO intervention. The patients with abdominal infection demonstrated a lower mortality rate, fewer CD3 T lymphocytes, and fewer helper/inducer T lymphocytes in the FO group compared with the control group. After 7 days, the Marshall Score was lower in the FO group than in the control group. Conclusion: FO has positive effects in terms of improving the long-term prognosis of patients with severe sepsis with AGI III. Patients with a high IAP and abdominal infection might experience greater benefit from FO. This effect might be due, in part, to immunomodulation.
Abbreviations used: AGI: Acute gastrointestinal injury; FO: Fish oil; TPN: Total parenteral nutrition; IAP: Intra-abdominal pressure; ICU: Intensive Care Unit; MODS: Multiple organ dysfunction syndrome; TLR4: Toll-like receptor 4; DNR: Do Not Resuscitate; WGAP: Working Group of Abdominal Problem; EN: Enteral nutrition; BP: Low blood pressure; CRI: Catheter-related infection; PBS: Phosphate-buffered saline; ELFA: Enzyme-linked fluorescent assay; SD: Standard deviation; PUFAs: Polyunsaturated fatty acids; EPA: Eicosapentenoic acid; DHA: Docosahexaenoic acid.