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Healthou_Perioperative administration of parenteral fish oil supplements in a routine clinical setting improves patient outcome after major abdominal surgery

Evangelos Tsekosa, 1, 

  • Clemens Reuterb, 
  • Peter Stehlec, Corresponding author contact information, E-mail the corresponding author, 
  • Gerhard Boedena
    • a Department of Anesthesiology and Intensive Care, Krankenhaus der Barmherzigen Brüder, München, Germany
    • b Surgical Department, Krankenhaus der Barmherzigen Brüder, München, Germany
    • c Department of Nutrition Science, Universität Bonn, Endenicher Allee 11-13, 53115 Bonn, Germany
     
    Referred to by

    Abstract

    Background & aims: It is hypothesized that provision of pre- and/or postoperative omega-3 fatty acids to surgical patients in clinical routine improves clinical outcome.

    Methods: Retrospective evaluation of a 2-year-longitudinal data base of ICU patients (n=249) elected for major abdominal surgery. Group I (n=110): postoperative standard parenteral nutrition (1.2 g amino acids, 0.3 g glutamine dipeptide, 0.6 g lipids, 4 g/kg glucose; energy ratio glucose to lipid 2:1); group II (n=86): part of postoperative lipid emulsion replaced by fish oil; group III (n=53): in addition 2–3 days preoperative fish oil supplementation (max. 100 ml/d).

    Results: A decrease in mortality was observed in group III compared to group I (P=0.02). The number of patients requiring mechanical ventilation was lower with perioperative fish oil (n=34 in groups I and II. 10 in III,P<0.05). The number of days in ICU was not different (group I: 7.6 days, group II: 7.0, group III: 7.3), the length of hospital stay was shorter in group I (group I: 29.2 days, group II: 24.9, group III: 22.2, P<0.05 vs I).

    Conclusions: In a retrospective evaluation, perioperative provision of parenteral fish oil (ca. 10 g/day) beneficially influences patient outcome probably by modulating the immune response.

    Keywords

    • Intravenous fish oil; 
    • Postoperative patients; 
    • Outcome; 
    • Retrospective evaluation

    Figures and tables from this article:

    Full-size image (14 K)
    Figure 1. 

    Mortality rates in the three groups. **P<0.02 vs group I.

    Table 1.

    Patient characteristics (mean±SD).

     

    Group I: postoperative TPN without fish oil.

    Group II: postoperative TPN with fish oil.

    Group III: preoperative fish oil supplements and postoperative TPN with fish oil.

     

    View Within Article
    Table 2.

    Surgical procedures.

     

    Group I: postoperative TPN without fish oil.

    Group II: postoperative TPN with fish oil.

    Group III: preoperative fish oil supplements and postoperative TPN with fish oil.

     

    View Within Article
    Table 3.

    Effects of treatment of secondary end points (mean±SD).

     

    Group I: postoperative TPN without fish oil.

    Group II: postoperative TPN with fish oil.

    Group III: preoperative fish oil supplements and postoperative TPN with fish oil.

     

    View Within Article
    1

    Present address: Universitätsklinikum Eppendorf, Hamburg, Germany.

    from source:http://www.sciencedirect.com/science/article/pii/S0261561403001626


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