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Fish oil after abdominal aorta aneurysm surgery.

M M Berger1, L Tappy, J P Revelly

  • 1Department of Intensive Care Medicine, CHUV, Lausanne, Switzerland. mette.berger@chuv.ch

European Journal of Clinical Nutrition
|June 1, 2007
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Summary

Fish oil (FO) parenteral nutrition (PN) was well tolerated after abdominal aortic aneurysm (AAA) surgery. FO-PN increased plasma omega-3 fatty acids and showed trends toward reduced body temperature and shorter hospital stays.

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Area of Science:

  • Surgical nutrition
  • Intensive care medicine
  • Lipid metabolism

Background:

  • Major abdominal aortic aneurysm (AAA) surgery can trigger significant inflammatory responses.
  • Parenteral nutrition (PN) is crucial for post-operative recovery, but lipid choices may influence outcomes.
  • Fish oil (FO) is known for its anti-inflammatory properties, suggesting potential benefits in surgical recovery.

Purpose of the Study:

  • To evaluate the clinical impact and safety of FO-containing PN after AAA surgery.
  • To compare FO-PN with standard PN regarding inflammatory and metabolic markers.
  • To assess the effect of FO-PN on patient recovery metrics like length of stay.

Main Methods:

  • A randomized trial comparing standard PN (50% medium-chain triglycerides [MCT]/50% long-chain triglycerides [LCT]) with FO-PN (10% FO, 50% MCT, 40% LCT).
  • Energy targets were standardized to 1.3 times resting energy expenditure, measured by indirect calorimetry.
  • Data collected included blood parameters, glucose turnover, muscle microdialysis, body temperature, ICU, and hospital stay duration.

Main Results:

  • Both PN formulations were well-tolerated, with no significant differences in safety parameters, inflammation, or organ failure.
  • FO-PN significantly increased plasma docosahexaenoic acid and eicosapentaenoic acid levels by day 4.
  • Trends suggested lower postoperative body temperature and shorter ICU and hospital stays in the FO-PN group.

Conclusions:

  • Fish oil-containing parenteral nutrition is safe and well-tolerated following AAA surgery.
  • FO-PN effectively enhances plasma levels of beneficial omega-3 polyunsaturated fatty acids.
  • FO-PN demonstrated a trend towards improved clinical outcomes, including reduced length of stay.