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-3 Fatty Acids–Supplemented Parenteral Nutrition Decreases Hyperinflammatory Response and Attenuates Systemic Disease Sequelae in Severe Acute Pancreatitis: A Randomized and Controlled Study
Xinying Wang, MD,
Weiqin Li, MD,
Ning Li, MD and
Jieshou Li, MD
From the Research Institute of General Surgery, Jinling Hospital,
Nanjing, China.
Address correspondence to: Jieshou Li, MD, Research Institute of General
Surgery, Jinling Hospital, 305 Zhongshan East Road, Nanjing, 210002, China;
e-mail:
wxinying{at}263.net.
Background: The objective of this study was to investigate whether
altering the fatty acid (FA) profile by -3 FA supplementation affects
inflammatory response and systemic disease sequelae in severe acute
pancreatitis. Methods: Forty severe acute pancreatitis patients were
enrolled and randomly assigned to receive parenteral nutrition (PN) for 5 days
in a double-blind manner. Patients received PN with identical amounts of amino
acids (1.25 g/kg/d), glucose (3 g/kg/d), and fat (1 g/kg/d) but different
lipid compositions: the control group received a soybean oil (SO; Lipovenos
20%; Fresenius, Germany)–based fat solution and the -3 FA group
was supplemented with 0.15 - 0.2 g/kg/d fish oil (FO; Omegaven 10%; Fresenius,
Germany). Serum concentrations of eicosapentaenoic acid (EPA), interleukin-6,
C-reactive protein (CRP), white blood cell count, and routine respiratory and
renal parameters were measured before PN, and again on day 6 after starting
PN. Outcomes such as infection morbidity, mortality, intensive care unit time,
and length of hospital stay were recorded. Results: Patients treated
with FO had a significantly higher EPA concentration (P < .01),
lower CRP level (P < .05), and better oxygenation index
(P < .05) after 5 days of PN. Moreover, the number of days of
continuous renal replacement therapy (CRRT) in the -3 FAs group was
significantly less than that in the control group (P < .05).
Conclusions: PN supplemented with -3 FAs diminishes the
hyperinflammatory response by the EPA increase and the proinflammatory
cytokine decrease in severe acute pancreatitis. This, together with improved
respiratory function and shortened CRRT time, suggests that the systemic
response to pancreatic and organ injury is attenuated.
Key Words: -3 fatty acids severe acute pancreatitis fish oil inflammatory response respiratory function fatty acids pancreatic disease lipids
Journal of Parenteral and Enteral Nutrition, Vol. 32, No. 3,
236-241 (2008)
DOI: 10.1177/0148607108316189

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