Effects of a fish oil containing lipid emulsion on plasma phospholipid fatty acids, inflammatory markers, and clinical outcomes in septic patients: a randomized, controlled clinical trial.
Effects of a fish oil containing lipid emulsion on plasma phospholipid fatty acids, inflammatory markers, and clinical outcomes in septic patients: a randomized, controlled clinical trial.
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DOI：
10.1186/cc8844
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Calder PC
中科院分区：
文献类型：
--
作者：
Barbosa VM;Miles EA;Calhau C;Lafuente E;Calder PC
肠胃外鱼油在脓毒症患者中的作用尚未得到广泛研究。本研究调查了胃肠外鱼油对血浆磷脂脂肪酸、炎症介质和临床结局的影响。25例全身炎症反应综合征或脓毒症患者，预计需要肠外营养，随机接受中链脂肪酸和大豆油的50：50混合物或中链脂肪酸、大豆油和鱼油的50：40：10混合物。从入院起连续5天给予肠外营养。在血浆和脂多糖刺激的全血培养上清液中测定细胞因子和类花生酸。测定血浆磷脂酰胆碱中的脂肪酸。鱼油能显著增加血浆磷脂酰胆碱中的二十碳五烯酸（P < 0.001）。鱼油组血浆白细胞介素（IL）-6浓度下降幅度更大，而IL-10浓度下降幅度更小（均P < 0.001）。在第6天，鱼油组的PO 2/FiO 2比值显著较高（P = 0.047），鱼油组中PO 2/FiO 2 <200和<300的患者较少（分别为P = 0.001和P = 0.015）。两组的通气天数、重症监护室（ICU）住院时间和死亡率无差异。鱼油组的住院时间往往较短（22 ± 7 vs. 55 ± 16天; P = 0.079），当仅纳入存活患者时，这一差异变得显著（28 ± 9 vs. 82 ± 19天; P = 0.044）。向脓毒症ICU患者提供的肠外营养中包含鱼油可增加血浆二十碳五烯酸，改变炎性细胞因子浓度并改善气体交换。这些变化与住院时间缩短的趋势有关。临床试验注册号ISRCTN 89432944
The effect of parenteral fish oil in septic patients is not widely studied. This study investigated the effects of parenteral fish oil on plasma phospholipid fatty acids, inflammatory mediators, and clinical outcomes. Twenty-five patients with systemic inflammatory response syndrome or sepsis, and predicted to need parenteral nutrition were randomized to receive either a 50:50 mixture of medium-chain fatty acids and soybean oil or a 50:40:10 mixture of medium-chain fatty acids, soybean oil and fish oil. Parenteral nutrition was administrated continuously for five days from admission. Cytokines and eicosanoids were measured in plasma and in lipopolysaccharide-stimulated whole blood culture supernatants. Fatty acids were measured in plasma phosphatidylcholine. Fish oil increased eicosapentaenoic acid in plasma phosphatidylcholine (P < 0.001). Plasma interleukin (IL)-6 concentration decreased significantly more, and IL-10 significantly less, in the fish oil group (both P < 0.001). At Day 6 the ratio PO2/FiO2 was significantly higher in the fish oil group (P = 0.047) and there were fewer patients with PO2/FiO2 <200 and <300 in the fish oil group (P = 0.001 and P = 0.015, respectively). Days of ventilation, length of intensive care unit (ICU) stay and mortality were not different between the two groups. The fish oil group tended to have a shorter length of hospital stay (22 ± 7 vs. 55 ± 16 days; P = 0.079) which became significant (28 ± 9 vs. 82 ± 19 days; P = 0.044) when only surviving patients were included. Inclusion of fish oil in parenteral nutrition provided to septic ICU patients increases plasma eicosapentaenoic acid, modifies inflammatory cytokine concentrations and improves gas exchange. These changes are associated with a tendency towards shorter length of hospital stay. Clinical Trials Registration Number ISRCTN89432944
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DOI：
10.1177/0148607104028003142
发表时间：
2004-05-01
期刊：
JPEN. Journal of parenteral and enteral nutrition
影响因子：
--
作者：
Antebi, H;Mansoor, O;Alcindor, L G
通讯作者：
Alcindor, L G
影响因子：
38.9
作者：
Mayer K;Fegbeutel C;Hattar K;Sibelius U;Krämer HJ;Heuer KU;Temmesfeld-Wollbrück B;Gokorsch S;Grimminger F;Seeger W
通讯作者：
Seeger W
影响因子：
3.1
作者：
Arnalich, F;Garcia-Palomero, E;Montiel, C
通讯作者：
Montiel, C
DOI：
10.1006/bbrc.1997.6337
发表时间：
1997-03-27
影响因子：
3.1
作者：
Kohler, NG;Joly, A
通讯作者：
Joly, A
影响因子：
7.1
作者：
MASCIOLI, EA;IWASA, Y;BLACKBURN, GL
通讯作者：
BLACKBURN, GL