Intravenous omega-3 fatty acids are associated with better clinical outcome and less inflammation in patients with predicted severe acute pancreatitis: A randomised double blind controlled trial.
APACHE
Administration, Intravenous
Adult
Aged
Aged, 80 and over
C-Reactive Protein
/ analysis
Double-Blind Method
Fat Emulsions, Intravenous
Fatty Acids, Omega-3
/ administration & dosage
Female
Fish Oils
/ administration & dosage
Humans
Inflammation
/ prevention & control
Leukocyte Count
Male
Middle Aged
Multiple Organ Failure
/ prevention & control
Pancreatitis
/ therapy
Systemic Inflammatory Response Syndrome
/ prevention & control
Treatment Outcome
United Kingdom
C-reactive protein
Fish oil
Omega-3
Organ failure
Severe acute pancreatitis
Systemic inflammatory response syndrome
Journal
Clinical nutrition (Edinburgh, Scotland)
ISSN: 1532-1983
Titre abrégé: Clin Nutr
Pays: England
ID NLM: 8309603
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
15
08
2017
revised:
08
02
2018
accepted:
02
04
2018
entrez:
14
9
2020
pubmed:
15
9
2020
medline:
7
8
2021
Statut:
ppublish
Résumé
Omega-3 fatty acids (FA) can ameliorate the hyper-inflammatory response that occurs in conditions such as severe acute pancreatitis (SAP) and this may improve clinical outcome. We tested the hypothesis that parenteral omega-3 FA from a lipid emulsion that includes fish oil could be beneficial in patients with predicted SAP by reducing C-reactive protein (CRP) concentration (primary outcome), and modulating the inflammatory response and improving clinical outcome (secondary outcomes). In a phase II randomized double-blind single-centre controlled trial, patients with predicted SAP were randomised to receive a daily infusion of fish oil containing lipid emulsion (Lipidem® 20%, BBraun) for 7 days (n = 23) or a daily infusion of a lipid emulsion without fish oil (Lipofundin® MCT 20%, BBraun) (n = 22). On admission, both groups had comparable pancreatitis predicted severity and APACHE II scores. Administration of fish oil resulted in lower total blood leukocyte number (P = 0.04), CRP (P = 0.013), interleukin-8 (P = 0.05) and intercellular adhesion molecule 1 (P = 0.01) concentrations, multiple organ dysfunction score, sequential organ failure assessment score (P = 0.004), early warning score (P = 0.01), and systemic inflammatory response syndrome (P = 0.03) compared to the control group. The fish oil group had fewer new organ failures (P = 0.07), lower critical care admission rate (P = 0.06), shorter critical care stay (P = 0.03) and shorter total hospital stay (P = 0.04). It is concluded that intravenous administration of a fish oil containing lipid emulsion, a source of omega-3 FA, improves clinical outcomes in patients with predicted SAP, benefits that may be linked to reduced inflammation. CLINICALTRIALS. NCT01745861. EudraCT (2010-018660-16).
Sections du résumé
BACKGROUND AND AIMS
Omega-3 fatty acids (FA) can ameliorate the hyper-inflammatory response that occurs in conditions such as severe acute pancreatitis (SAP) and this may improve clinical outcome. We tested the hypothesis that parenteral omega-3 FA from a lipid emulsion that includes fish oil could be beneficial in patients with predicted SAP by reducing C-reactive protein (CRP) concentration (primary outcome), and modulating the inflammatory response and improving clinical outcome (secondary outcomes).
METHODS
In a phase II randomized double-blind single-centre controlled trial, patients with predicted SAP were randomised to receive a daily infusion of fish oil containing lipid emulsion (Lipidem® 20%, BBraun) for 7 days (n = 23) or a daily infusion of a lipid emulsion without fish oil (Lipofundin® MCT 20%, BBraun) (n = 22).
RESULTS
On admission, both groups had comparable pancreatitis predicted severity and APACHE II scores. Administration of fish oil resulted in lower total blood leukocyte number (P = 0.04), CRP (P = 0.013), interleukin-8 (P = 0.05) and intercellular adhesion molecule 1 (P = 0.01) concentrations, multiple organ dysfunction score, sequential organ failure assessment score (P = 0.004), early warning score (P = 0.01), and systemic inflammatory response syndrome (P = 0.03) compared to the control group. The fish oil group had fewer new organ failures (P = 0.07), lower critical care admission rate (P = 0.06), shorter critical care stay (P = 0.03) and shorter total hospital stay (P = 0.04).
CONCLUSIONS
It is concluded that intravenous administration of a fish oil containing lipid emulsion, a source of omega-3 FA, improves clinical outcomes in patients with predicted SAP, benefits that may be linked to reduced inflammation. CLINICALTRIALS.
GOV NUMBER
NCT01745861.
EU CLINICAL TRIALS REGISTER
EudraCT (2010-018660-16).
Identifiants
pubmed: 32921364
pii: S0261-5614(18)30132-8
doi: 10.1016/j.clnu.2018.04.003
pii:
doi:
Substances chimiques
Fat Emulsions, Intravenous
0
Fatty Acids, Omega-3
0
Fish Oils
0
C-Reactive Protein
9007-41-4
Banques de données
ClinicalTrials.gov
['NCT01745861']
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
2711-2719Informations de copyright
Copyright © 2018. Published by Elsevier Ltd.