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Fish Oil Found to Help Critical ICU Patients
1/22/2010
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Clinical trial’s results fit the known properties of omega-3s, and affirm prior research on omega-3s in post-surgical patients and premature babies
by Craig Weatherby


British and Portuguese researchers report the encouraging results of a clinical trial in which they tested intravenous (IV) fish oil in patients suffering from sepsis.

Sepsis is a very serious illness in which the immune system goes into overdrive, potentially causing crippling or fatal damage to patients’ organs.

The results suggest that by adding fish oil to IV feeding formulas, hospitals can alleviate symptoms of sepsis among their intensive care unit (ICU) patients, and shorten their stays.

Research performed at several European universities has indicated that omega-3s can help patients undergoing major surgery (see “Surgical benefits seen”, below).

And U.S. studies show that omega-3s can protect the livers of premature babies getting intravenous (IV) nutrition… see “‘Preemies’ have been saved”, below.

The new UK-Portuguese findings add ICU care to the list of potential uses for omega-3-enhanced medical nutrition.

Critically ill patients with sepsis benefited from IV omega-3s
Researchers from the University of Southampton worked with a hospital in Portugal to conduct a randomized, controlled trial in 23 ICU patients with sepsis (Barbosa VM et al. 2010).

The study was led by Philip Calder, Ph.D., a professor of nutritional immunology at Britain’s University of Southampton, and a prominent researcher into omega-3s and inflammation.

The patients were randomly assigned to receive one of two intravenous nutrition formulas for five days following their admission to the ICU:
  • A standard, 50:50 misture of medium-chain fatty acids and soybean oil.
  • An experimental mixture providing medium-chain fatty acids (50 percent), soybean oil (40 percent) and fish oil (10 percent).
The British-Portuguese team found that the group receiving the test formula containing 10 percent fish oil had better gas exchange in the lungs, compared with the group receiving standard IV formula.

(In other words, the fish oil group enjoyed enhanced transfer of oxygen from inhaled air into the blood, and enhanced transfer of carbon dioxide from the blood into exhaled air.)

Intravenous fish oil also reduced production of the inflammatory chemicals produced by the immune system during sepsis, excess amounts of which can lead to blood clots and organ failure.

And, the patients given fish oil left the hospital earlier than those who received traditional nutrition.

As Calder said in a press release, “The results of this study are very encouraging, because they suggest a way that the condition of these very sick patients can be improved” (UOS 2010).

He went on to explain why standard, vegetable-oil-based IV formulas can be unhealthful:

“Traditional solutions use soybean oil, which does not contain the omega-3 fatty acids contained in fish oil that act to reduce inflammatory responses. In fact, soybean oil is rich in omega-6 acids that may actually promote inflammation in an excessive or unbalanced supply.” (UOS 2010)

The problem with omega-6-rich IV formulas
Soybean oil and other vegetable oils are high in an omega-6 fatty acid (linoleic acid), which the body uses to make the pro-inflammatory members of a family of immune-system chemicals called prostaglandins.

In contrast, the long-chain omega-3s (EPA and DHA) found in our cell membranes and in fish fatbut not in plant foods— are precursors for anti-inflammatory prostaglandins (This precursor role is specific to EPA, but the body can easily make EPA from DHA as needed).

Recently developed experimental IV formulas such as Germany’s Omegaven™ substitute some of the soybean oil with fish oils, which are naturally high in long-chain omega-3s (EPA and DHA).

Prior research shows that omega-3-enriched IV formulas reduce oxidative stress and protect patients’ liver function while moderating inflammation and immune responses.

Omega-3 benefits seen in “preemies” and surgical patients
We first came across research on IV omega-3s through a 2006 Boston Globe article concerning the life-saving benefits of omega-3s among premature babies, many of whom must receive liquid IV nutrition (see “Omega-3s May Save “Premies” Lives: A Rewarding Response”).

And researchers at several European universities have found that omega-3s benefit patients undergoing major surgery.

As a German team wrote three years ago:

“…post-operative parenteral [intravenous] administration of omega-3-enriched lipid emulsions could have … [a beneficial] impact on the inflammatory response after abdominal surgery and could be used in standard post-operative care...” (Senkal M et al 2007).

For more on that topic, see “Omega-3s Enhance Post-Surgery Outcomes”.


Sources
  • Barbosa VM, Miles EA, Calhau C, Lafuente E, Calder PC. 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. Crit Care. 2010 Jan 19;14(1):R5. [Epub ahead of print]
  • Calder PC, Jensen GL, Koletzko BV, Singer P, Wanten GJ. Lipid emulsions in parenteral nutrition of intensive care patients: current thinking and future directions. Intensive Care Med. 2010 Jan 14. [Epub ahead of print]
  • Grimm H, Mertes N, Goeters C, Schlotzer E, Mayer K, Grimminger F, Furst P. Improved fatty acid and leukotriene pattern with a novel lipid emulsion in surgical patients. Eur J Nutr. 2006 Feb;45(1):55-60. Epub 2005 Jul 22. 
  • Heller AR, Rossel T, Gottschlich B, Tiebel O, Menschikowski M, Litz RJ, Zimmermann T, Koch T. Omega-3 fatty acids improve liver and pancreas function in postoperative cancer patients. Int J Cancer. 2004 Sep 10;111(4):611-6.
  • Senkal M, Geier B, Hannemann M, Deska T, Linseisen J, Wolfram G, Adolph M. Supplementation of {omega}-3 Fatty acids in parenteral nutrition beneficially alters phospholipid Fatty Acid pattern. JPEN J Parenter Enteral Nutr. 2007 Jan-Feb;31(1):12-7.
  • Senkal M, Haaker R, Linseisen J, Wolfram G, Homann HH, Stehle P. Preoperative oral supplementation with long-chain Omega-3 fatty acids beneficially alters phospholipid fatty acid patterns in liver, gut mucosa, and tumor tissue. JPEN J Parenter Enteral Nutr. 2005 Jul-Aug;29(4):236-40.
  • Stehr SN, Heller AR. Omega-3 fatty acid effects on biochemical indices following cancer surgery. Clin Chim Acta. 2006 Nov;373(1-2):1-8. Epub 2006 May 16. Review.
  • University of Southampton (UOS). Research into fish oil suggests health benefits for seriously ill patients. January 19, 2010. Accessed at http://www.soton.ac.uk/mediacentre/news/2010/jan/10_04.shtml

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