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Related Experiment Video

Updated: Jan 31, 2026

NMR Spectroscopy as a Robust Tool for the Rapid Evaluation of the Lipid Profile of Fish Oil Supplements
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Fish Oil and Perioperative Bleeding.

Emmanuel Akintoye1, Prince Sethi2, William S Harris2,3

  • 1Division of Cardiovascular Medicine, University of Iowa Hospitals and Clinics (E.A.).

Circulation. Cardiovascular Quality and Outcomes
|December 21, 2018
PubMed
Summary
This summary is machine-generated.

Fish oil supplementation did not increase perioperative bleeding in patients undergoing cardiac surgery and even reduced blood transfusions. Higher omega-3 polyunsaturated fatty acids (n-3-PUFA) levels were linked to a lower bleeding risk, challenging current guidelines.

Keywords:
chest tubesfish oilshemorrhageriskthoracic surgery

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Area of Science:

  • Cardiovascular Medicine
  • Surgical Outcomes
  • Nutritional Science

Background:

  • Fish oil is commonly used for hypertriglyceridemia and cardiovascular disease prevention.
  • Concerns exist regarding fish oil's potential to increase bleeding risk, leading to recommendations against its use before surgery.
  • This study investigates the actual perioperative bleeding risk associated with fish oil supplementation.

Purpose of the Study:

  • To evaluate the effect of fish oil supplementation on perioperative bleeding in patients undergoing major cardiac surgery.
  • To determine if fish oil use necessitates delaying elective procedures or cessation before surgery.
  • To explore the relationship between achieved omega-3 fatty acid levels and bleeding risk.

Main Methods:

  • A multinational, placebo-controlled trial involving 1516 patients undergoing coronary artery bypass graft or valve surgery.
  • Patients received either perioperative fish oil (eicosapentaenoic acid + docosahexaenoic acid) or a placebo.
  • Primary outcome: major perioperative bleeding (Bleeding Academic Research Consortium definition). Secondary outcomes included bleeding definitions, chest tube output, and blood transfusions.

Main Results:

  • Fish oil supplementation did not increase the risk of major perioperative bleeding compared to placebo (OR, 0.81; 95% CI, 0.53-1.24).
  • The fish oil group showed significantly fewer blood transfusions (mean 1.61 vs. 1.92, P<0.001).
  • Higher plasma phospholipid omega-3 polyunsaturated fatty acids (n-3-PUFA) levels were associated with a reduced risk of bleeding.

Conclusions:

  • Perioperative fish oil supplementation is safe and does not increase bleeding risk in cardiac surgery patients.
  • Fish oil use may lead to a reduction in the number of blood transfusions required.
  • Findings suggest reconsidering current recommendations to stop fish oil or delay procedures before cardiac surgery.