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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

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
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
Background & aims: N-3 fatty acids (FA) may have benefits in ICU patients. The aims were to identify whether FA status is altered in critical illness and to evaluate the effect of supplemental intravenous n-3 FA on plasma FA status and clinical outcome in ICU patients receiving enteral nutrition.
Methods: Enterally fed patients (n ¼ 49; 60e80 years) were recruited in the first 48 h of ICU admission. Fifteen patients received n-3 FA emulsion (0.2 g/kg) over 6 h for 3 consecutive days, and 34 patients did not (control). Samples were collected before supplementation, and 24 and 72 h after the third infusion. Nineteen healthy elderly subjects were also studied; they gave a single blood sample. FA were measured in plasma phosphatidylcholine (PC).
Results: Critically ill patients had altered plasma PC FA compared with healthy elderly subjects. Surviving ICU patients had higher levels of docosahexaenoic acid and total n-3 FA and a lower ratio of n-6:n-3 FA in plasma PC than non-survivors. Infusion of n-3 FA increased eicosapentaenoic, docosahexaenoic and total n-3 FA, and decreased arachidonic and total n-6 FA and n-6:n-3 FA and arachidonic:eicosapentaenoic acid ratios. Gas exchange was enhanced 72 h after the third n-3 FA infusion (p ¼ 0.001).
Conclusions: Critically ill patients may have altered plasma FA profiles. A higher total n-3 FA and docosahexaenoic acid content in plasma PC is associated with survival and improved gas exchange.
fish oil, omega-3 fatty acid, lipid emulsion, icu, critical illness
0261-5614
599-605
Barros, Karina V.
769c3b35-ed93-4917-8e45-08712aed878d
Cassulino, Ana Paula
0f8a6606-141a-4c75-8cb2-9a174eecf040
Schalch, Lívia
7bf9ecee-2c86-4835-85cb-252adca10980
Della Valle Munhoz, Eduardo
347ed689-065f-4ca4-9ee5-ae5984f19fe6
Manetta, José Antonio
13a58f66-fcc3-4dca-9cea-d6317d98627c
Noakes, Paul S.
0ed50cd9-de73-4851-8039-ee72860d8ae5
Miles, Elizabeth A.
20332899-ecdb-4214-95bc-922dde36d416
Calder, Philip C.
1797e54f-378e-4dcb-80a4-3e30018f07a6
Flor Silveira, Vera L.
29405df7-a0a3-43f1-9f79-a13cd39db372
Barros, Karina V.
769c3b35-ed93-4917-8e45-08712aed878d
Cassulino, Ana Paula
0f8a6606-141a-4c75-8cb2-9a174eecf040
Schalch, Lívia
7bf9ecee-2c86-4835-85cb-252adca10980
Della Valle Munhoz, Eduardo
347ed689-065f-4ca4-9ee5-ae5984f19fe6
Manetta, José Antonio
13a58f66-fcc3-4dca-9cea-d6317d98627c
Noakes, Paul S.
0ed50cd9-de73-4851-8039-ee72860d8ae5
Miles, Elizabeth A.
20332899-ecdb-4214-95bc-922dde36d416
Calder, Philip C.
1797e54f-378e-4dcb-80a4-3e30018f07a6
Flor Silveira, Vera L.
29405df7-a0a3-43f1-9f79-a13cd39db372

Barros, Karina V., Cassulino, Ana Paula, Schalch, Lívia, Della Valle Munhoz, Eduardo, Manetta, José Antonio, Noakes, Paul S., Miles, Elizabeth A., Calder, Philip C. and Flor Silveira, Vera L. (2013) 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. Clinical Nutrition, 32 (4), 599-605. (doi:10.1016/j.clnu.2012.10.016). (PMID:23260750)

Record type: Article

Abstract

Background & aims: N-3 fatty acids (FA) may have benefits in ICU patients. The aims were to identify whether FA status is altered in critical illness and to evaluate the effect of supplemental intravenous n-3 FA on plasma FA status and clinical outcome in ICU patients receiving enteral nutrition.
Methods: Enterally fed patients (n ¼ 49; 60e80 years) were recruited in the first 48 h of ICU admission. Fifteen patients received n-3 FA emulsion (0.2 g/kg) over 6 h for 3 consecutive days, and 34 patients did not (control). Samples were collected before supplementation, and 24 and 72 h after the third infusion. Nineteen healthy elderly subjects were also studied; they gave a single blood sample. FA were measured in plasma phosphatidylcholine (PC).
Results: Critically ill patients had altered plasma PC FA compared with healthy elderly subjects. Surviving ICU patients had higher levels of docosahexaenoic acid and total n-3 FA and a lower ratio of n-6:n-3 FA in plasma PC than non-survivors. Infusion of n-3 FA increased eicosapentaenoic, docosahexaenoic and total n-3 FA, and decreased arachidonic and total n-6 FA and n-6:n-3 FA and arachidonic:eicosapentaenoic acid ratios. Gas exchange was enhanced 72 h after the third n-3 FA infusion (p ¼ 0.001).
Conclusions: Critically ill patients may have altered plasma FA profiles. A higher total n-3 FA and docosahexaenoic acid content in plasma PC is associated with survival and improved gas exchange.

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Published date: August 2013
Keywords: fish oil, omega-3 fatty acid, lipid emulsion, icu, critical illness
Organisations: Human Development & Health

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Local EPrints ID: 354241
URI: https://eprints.soton.ac.uk/id/eprint/354241
ISSN: 0261-5614
PURE UUID: f726fd83-5c66-4655-b030-7c7c9c8b873d
ORCID for Paul S. Noakes: ORCID iD orcid.org/0000-0002-2678-1971
ORCID for Elizabeth A. Miles: ORCID iD orcid.org/0000-0002-8643-0655

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Date deposited: 05 Jul 2013 11:16
Last modified: 20 Jul 2019 01:25

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Contributors

Author: Karina V. Barros
Author: Ana Paula Cassulino
Author: Lívia Schalch
Author: Eduardo Della Valle Munhoz
Author: José Antonio Manetta
Author: Paul S. Noakes ORCID iD
Author: Elizabeth A. Miles ORCID iD
Author: Vera L. Flor Silveira

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