Intravenous omega-3 fatty acids are associated with better clinical outcome and less inflammation in patients with predicted severe acute pancreatitis: a randomised double blind controlled trial
Intravenous omega-3 fatty acids are associated with better clinical outcome and less inflammation in patients with predicted severe acute pancreatitis: a randomised double blind controlled trial
Background and aims: omega-3 fatty acids (FA) can ameliorate the hyper-inflammatory response that occurs in conditions such as severe acute pancreatitis (SAP) and this may improve clinical outcome. We tested the hypothesis that parenteral omega-3 FA from a lipid emulsion that includes fish oil could be beneficial in patients with predicted SAP by reducing C-reactive protein (CRP) concentration (primary outcome), and modulating the inflammatory response and improving clinical outcome (secondary outcomes).
Methods: in a phase II randomized double-blind single-centre controlled trial, patients with predicted SAP were randomised to receive a daily infusion of fish oil containing lipid emulsion (Lipidem® 20%, BBraun) for 7 days (n = 23) or a daily infusion of a lipid emulsion without fish oil (Lipofundin® MCT 20%, BBraun) (n = 22).
Results: on admission, both groups had comparable pancreatitis predicted severity and APACHE II scores. Administration of fish oil resulted in lower total blood leukocyte number (P = 0.04), CRP (P = 0.013), interleukin-8 (P = 0.05) and intercellular adhesion molecule 1 (P = 0.01) concentrations, multiple organ dysfunction score, sequential organ failure assessment score (P = 0.004), early warning score (P = 0.01), and systemic inflammatory response syndrome (P = 0.03) compared to the control group. The fish oil group had fewer new organ failures (P = 0.07), lower critical care admission rate (P = 0.06), shorter critical care stay (P = 0.03) and shorter total hospital stay (P = 0.04).
Conclusions: it is concluded that intravenous administration of a fish oil containing lipid emulsion, a source of omega-3 FA, improves clinical outcomes in patients with predicted SAP, benefits that may be linked to reduced inflammation.
2711-2719
Al-Leswas, D.
9a9b5f4d-1a75-4f74-a365-d1d27a3cc7a0
Eltweri, A.M.
fe0705e1-3e74-4624-b5d0-705ecf8d2d51
Chung, W.-Y.
8919bf63-6925-4c2d-89db-76189deb5ac6
Fisk, H.L.
2483d346-75dd-41b3-a481-10f8bb39cd9f
Calder, P.C.
1797e54f-378e-4dcb-80a4-3e30018f07a6
7 September 2020
Al-Leswas, D.
9a9b5f4d-1a75-4f74-a365-d1d27a3cc7a0
Eltweri, A.M.
fe0705e1-3e74-4624-b5d0-705ecf8d2d51
Chung, W.-Y.
8919bf63-6925-4c2d-89db-76189deb5ac6
Fisk, H.L.
2483d346-75dd-41b3-a481-10f8bb39cd9f
Calder, P.C.
1797e54f-378e-4dcb-80a4-3e30018f07a6
Al-Leswas, D., Eltweri, A.M. and Chung, W.-Y.
,
et al.
(2020)
Intravenous omega-3 fatty acids are associated with better clinical outcome and less inflammation in patients with predicted severe acute pancreatitis: a randomised double blind controlled trial.
Clinical Nutrition, 39 (9), .
(doi:10.1016/j.clnu.2018.04.003).
Abstract
Background and aims: omega-3 fatty acids (FA) can ameliorate the hyper-inflammatory response that occurs in conditions such as severe acute pancreatitis (SAP) and this may improve clinical outcome. We tested the hypothesis that parenteral omega-3 FA from a lipid emulsion that includes fish oil could be beneficial in patients with predicted SAP by reducing C-reactive protein (CRP) concentration (primary outcome), and modulating the inflammatory response and improving clinical outcome (secondary outcomes).
Methods: in a phase II randomized double-blind single-centre controlled trial, patients with predicted SAP were randomised to receive a daily infusion of fish oil containing lipid emulsion (Lipidem® 20%, BBraun) for 7 days (n = 23) or a daily infusion of a lipid emulsion without fish oil (Lipofundin® MCT 20%, BBraun) (n = 22).
Results: on admission, both groups had comparable pancreatitis predicted severity and APACHE II scores. Administration of fish oil resulted in lower total blood leukocyte number (P = 0.04), CRP (P = 0.013), interleukin-8 (P = 0.05) and intercellular adhesion molecule 1 (P = 0.01) concentrations, multiple organ dysfunction score, sequential organ failure assessment score (P = 0.004), early warning score (P = 0.01), and systemic inflammatory response syndrome (P = 0.03) compared to the control group. The fish oil group had fewer new organ failures (P = 0.07), lower critical care admission rate (P = 0.06), shorter critical care stay (P = 0.03) and shorter total hospital stay (P = 0.04).
Conclusions: it is concluded that intravenous administration of a fish oil containing lipid emulsion, a source of omega-3 FA, improves clinical outcomes in patients with predicted SAP, benefits that may be linked to reduced inflammation.
Text
YCLNU-D-17-00739R1
- Accepted Manuscript
More information
Accepted/In Press date: 2 April 2018
e-pub ahead of print date: 27 April 2018
Published date: 7 September 2020
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Local EPrints ID: 420117
URI: http://eprints.soton.ac.uk/id/eprint/420117
ISSN: 0261-5614
PURE UUID: 85d17a0c-89c9-4d9e-ad74-2b8d159f2a33
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Date deposited: 27 Apr 2018 16:30
Last modified: 16 Mar 2024 06:31
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Author:
D. Al-Leswas
Author:
A.M. Eltweri
Author:
W.-Y. Chung
Author:
H.L. Fisk
Corporate Author: et al.
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