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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
Correspondence Address:
Wei Wang
Department of Endocrinology, Shenzhen People's Hospital, The Second Clinical Hospital of Jinan University, No. 1017, Dongmen North Road, Luohu District, Shenzhen 518020, Guangdong
China
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/pm.pm_418_16
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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. |
