Original Article
European Journal of Clinical Nutrition (2008) 62, 1116–1122; doi:10.1038/sj.ejcn.1602817; published online 30 May 2007
Fish oil after abdominal aorta aneurysm surgery
Contributors: MMB, Conception, Design, Conduct, Methods, Statistics; LT, Conception, Design, Methods, Statistics; JPR, Conception, Design, Conduct, Statistics; BVK, Methods, Statistics; JG, Methods, Statistics; MCC, Conception, Conduct; JMC, Conception, Conduct; RLC, Conception, Design, Conduct.
M M Berger1, L Tappy2, J P Revelly1, B V Koletzko3, J Gepert3, J M Corpataux4, M C Cayeux1 and R L Chiolero1
- 1Department of Intensive Care Medicine, CHUV, Lausanne, Switzerland
- 2Physiology Institute, UNIL, Lausanne, Switzerland
- 3Division of Metabolic Disease and Nutrition, Childrens' Hospital Ludwig-Maximilians University of Munich, Germany
- 4Department of Thoracic Surgery, CHUV, Lausanne, Switzerland
Correspondence: Dr MM Berger, Service de Médecine Intensive Adulte et Centre des Brûlés, CHUV, BH-08.660, 46, rue du Bugnon, CH-1011 Lausanne, Switzerland. E-mail: mette.berger@chuv.ch
Received 14 December 2006; Revised 12 April 2007; Accepted 23 April 2007; Published online 30 May 2007.
Abstract
Objective:
Fish oil (FO) may attenuate the inflammatory response after major surgery such as abdominal aortic aneurysm (AAA) surgery. We aimed at evaluating the clinical impact and safety aspects of a FO containing parenteral nutrition (PN) after AAA surgery.
Methods:
Intervention consisted in 4 days of either standard (STD: Lipofundin medium-chain triglyceride (MCT): long-chain triglyceride (LCT)50%–MCT50%) or FO containing PN (FO: Lipoplus: LCT40%–MCT50%–FO10%). Energy target were set at 1.3 times the preoperative resting energy expenditure by indirect calorimetry. Blood sampling on days 0, 2, 3 and 4. Glucose turnover by the 2H2-glucose method. Muscle microdialysis. Clinical data: maximal daily T°, intensive care unit (ICU) and hospital stay.
Results:
Both solutions were clinically well tolerated, without any differences in laboratory safety parameters, inflammatory, metabolic data, or in organ failures. Plasma tocopherol increased similarly; with FO, docosahexaenoic and eicosapentaenoic acid increased significantly by day 4 versus baseline or STD. To increased postoperatively, with a trend to lower values in FO group (P=0.09). After FO, a trend toward shorter ICU stay (1.6
0.4 versus 2.30.4), and hospital stay (9.92.4 versus 11.32.7 days: P=0.19) was observed.
Conclusions:
Both lipid emulsions were well tolerated. FO-PN enhanced the plasma n–3 polyunsaturated fatty acid content, and was associated with trends to lower body temperature and shorter length of stay.
Keywords:
parenteral nutrition, inflammation, fish oil, outcome, supplementation critically ill
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