scholarly journals Intravenous Lipid Emulsions to Deliver Bioactive Omega-3 Fatty Acids for Improved Patient Outcomes

Marine Drugs ◽  
2019 ◽  
Vol 17 (5) ◽  
pp. 274 ◽  
Author(s):  
Philip C. Calder
Keyword(s):  
Fatty Acids ◽  
Parenteral Nutrition ◽  
Fish Oil ◽  
Hospital Stay ◽  
Critically Ill ◽  
Adult Patients ◽  
Lipid Emulsions ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
Meta Analyses

Lipids used in intravenous nutrition support (i.e., parenteral nutrition) provide energy, building blocks, and essential fatty acids. These lipids are included as emulsions since they need to be soluble in an aqueous environment. Fish oil is a source of bioactive omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid). Lipid emulsions, including fish oil, have been used for parenteral nutrition for adult patients post-surgery (mainly gastrointestinal). This has been associated with alterations in biomarkers of inflammation and immune defense, and in some studies, a reduction in length of intensive care unit and hospital stay. These benefits, along with a reduction in infections, are emphasized through recent meta-analyses. Perioperative administration of fish oil may be superior to postoperative administration, but this requires further exploration. Parenteral fish oil has been used in critically ill adult patients. Here, the influence on inflammatory processes, immune function, and clinical endpoints is less clear. However, some studies found reduced inflammation, improved gas exchange, and shorter length of hospital stay in critically ill patients if they received fish oil. Meta-analyses do not present a consistent picture but are limited by the small number and size of studies. More and better trials are needed in patient groups in which parenteral nutrition is used and where fish oil, as a source of bioactive omega-3 fatty acids, may offer benefits.

scholarly journals Lipids for intravenous nutrition in hospitalised adult patients: a multiple choice of options

2013 ◽  
Vol 72 (3) ◽  
pp. 263-276 ◽  
Author(s):  
Philip C. Calder
Keyword(s):  
Parenteral Nutrition ◽  
Fish Oil ◽  
Hospital Stay ◽  
Immune Function ◽  
Critically Ill ◽  
Adult Patients ◽  
Partial Replacement ◽  
Lipid Emulsions ◽  
Post Surgery ◽  
Wide Range

Lipids used in parenteral nutrition provide energy, building blocks and essential fatty acids. Traditionally, these lipids have been based on n-6 PUFA-rich vegetable oils particularly soyabean oil. This may not be optimal because soyabean oil may present an excessive supply of linoleic acid. Alternatives to use of soyabean oil include its partial replacement by medium-chain TAG, olive oil or fish oil, either alone or in combination. Lipid emulsions containing these alternatives are well tolerated without adverse effects in a wide range of hospitalised adult patients. Lipid emulsions that include fish oil have been used in parenteral nutrition in adult patients' post-surgery (mainly gastrointestinal). This has been associated with alterations in patterns of inflammatory mediators and in immune function and, in some studies, a reduction in length of intensive care unit and hospital stay. These benefits are emphasised through recent meta-analyses. Perioperative administration of fish oil may be superior to post-operative administration. Parenteral fish oil has been used in critically ill adults. Here, the influence on inflammatory processes, immune function and clinical endpoints is not clear, since there are too few studies and those that are available report contradictory findings. However, some studies found reduced inflammation, improved gas exchange and shorter length of hospital stay in critically ill patients if they receive fish oil. More and better trials are needed in patient groups in which parenteral nutrition is used and where fish oil may offer benefits.

Intravenous Lipid Emulsions in Infants: Is Balanced Better?

2019 ◽  
Vol 38 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Sara E. Rostas ◽  
Christopher McPherson
Keyword(s):  
Fatty Acids ◽  
Parenteral Nutrition ◽  
Neonatal Intensive Care ◽  
Intestinal Failure ◽  
Lipid Emulsions ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Omega 6

Parenteral nutrition (PN) is frequently required by extremely preterm infants due to gastrointestinal immaturity and complications of prematurity. Parenteral nutrition-associated cholestasis (PNAC) and intestinal failure-associated liver disease (IFALD) are common complications of prolonged PN. Plant-based intravenous lipid emulsions, containing proinflammatory omega-6 fatty acids and phytosterols, may contribute to these conditions as well as other comorbidities such as bronchopulmonary dysplasia and retinopathy of prematurity. Intravenous lipid emulsions containing animal-based fats, such as fish oil, contain fewer proinflammatory omega-6 fatty acids and more anti-inflammatory omega-3 fatty acids and antioxidants. SMOFlipid, recently Food and Drug Administration (FDA)-approved for adult use, is a blend of plant- and animal-based lipid emulsions with a favorable omega-6:omega-3 ratio that may prevent the development and progression of PNAC/IFALD in infants. Careful review of data supporting this alternative intravenous lipid emulsion is required prior to widespread use in neonatal intensive care.

Fish or Chips?

Physiology ◽  
2003 ◽  
Vol 18 (2) ◽  
pp. 50-54
Author(s):  
Axel R. Heller ◽  
Hermann J. Theilen ◽  
Thea Koch
Keyword(s):  
Fatty Acids ◽  
Fish Oil ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Extracellular Space ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
High Turnover ◽  
Omega 6 ◽  
Long Chain

Cell membranes are not simply barriers separating intracellular from extracellular space. Rather, they represent a dynamic high-turnover system that adapts to current demands. During inflammation, prostaglandins and leukotrienes are formed from membrane-derived phospholipids. Encouraging improvements in critically ill patients were observed after nutritional replacement of long-chain omega-6 fatty acids with long-chain omega-3-fatty acids, contained in fish oil.

scholarly journals Rationale for using new lipid emulsions in parenteral nutrition and a review of the trials performed in adults

2009 ◽  
Vol 68 (3) ◽  
pp. 252-260 ◽  
Author(s):  
Philip C. Calder
Keyword(s):  
Parenteral Nutrition ◽  
Fish Oil ◽  
Immune Function ◽  
Olive Oil ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Adult Patients ◽  
Partial Replacement ◽  
Lipid Emulsions ◽  
Post Surgery

Lipids traditionally used in parenteral nutrition are based on n-6 fatty acid-rich vegetable oils such as soyabean oil. This practice may not be optimal because it may present an excessive supply of linoleic acid. Alternatives to the use of soyabean oil include its partial replacement by so-called medium-chain TAG (MCT), olive oil or fish oil, either alone or in combination. Lipid emulsions containing MCT are well established, but those containing olive oil and fish oil, although commercially available, are still undergoing trials in different patient groups. Emulsions containing olive oil or fish oil are well tolerated and without adverse effects in a wide range of adult patients. An olive oil–soyabean oil emulsion has been used in quite small studies in critically-ill patients and in patients with trauma or burns with little real evidence of advantage over soyabean oil or MCT–soyabean oil. Fish oil-containing lipid emulsions have been used in adult patients post surgery (mainly gastrointestinal). This approach has been associated with alterations in patterns of inflammatory mediators and in immune function and, in some studies, a reduction in the length of stay in the intensive care unit and in hospital. One study indicates that peri-operative administration of fish oil may be superior to post-operative administration. Fish oil has been used in critically-ill adults. Here, the influence on inflammatory processes, immune function and clinical end points is not clear, since there are too few studies and those that are available report contradictory findings. One important factor is the dose of fish oil required to influence clinical outcomes. Further studies that are properly designed and adequately powered are required in order to strengthen the evidence base relating to the use of lipid emulsions that include olive oil and fish oil in critically-ill patients and in patients post surgery.

Reversal of severe parenteral nutrition-associated liver disease in an infant with short bowel syndrome using parenteral fish oil (Omega-3 fatty acids)

2008 ◽  
Vol 43 (6) ◽  
pp. 1191-1195 ◽  
Author(s):  
George Ekema ◽  
Diego Falchetti ◽  
Giovanni Boroni ◽  
Anna Rita Tanca ◽  
Cristian Altana ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Liver Disease ◽  
Parenteral Nutrition ◽  
Fish Oil ◽  
Short Bowel Syndrome ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
Short Bowel

Fish oil plus wheat germ oil have no prominent effect on homocysteine levels and nutritional indices in hemodialysis patients

2019 ◽  
pp. 1-7
Author(s):  
Hadeer Zakaria ◽  
Tarek M. Mostafa ◽  
Gamal A. El-Azab ◽  
Nagy AH Sayed-Ahmed
Keyword(s):  
Fatty Acids ◽  
Vitamin E ◽  
Fish Oil ◽  
Wheat Germ ◽  
Hemodialysis Patients ◽  
Nutritional Indices ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
Wheat Germ Oil ◽  
Serum Homocysteine

Abstract. Background: Elevated homocysteine levels and malnutrition are frequently detected in hemodialysis patients and are believed to exacerbate cardiovascular comorbidities. Omega-3 fatty acids have been postulated to lower homocysteine levels by up-regulating metabolic enzymes and improving substrate availability for homocysteine degradation. Additionally, it has been suggested that prevention of folate depletion by vitamin E consumption decreases homocysteine levels. However, data on the effect of omega-3 fatty acids and/or vitamin E on homocysteine levels and nutritional status have been inconclusive. Therefore, this study was planned to examine the effect of combined supplementation of fish oil, as a source of omega-3 fatty acids, with wheat germ oil, as a source of vitamin E, on homocysteine and nutritional indices in hemodialysis patients. Methods: This study was a randomized, double-blind, placebo-controlled trial. Forty-six hemodialysis patients were randomly assigned to two equally-sized groups; a supplemented group who received 3000 mg/day of fish oil [1053 mg omega-3 fatty acids] plus 300 mg/day of wheat germ oil [0.765 mg vitamin E], and a matched placebo group who received placebo capsules for 4 months. Serum homocysteine and different nutritional indices were measured before and after the intervention. Results: Twenty patients in each group completed the study. At the end of the study, there were no significant changes in homocysteine levels and in the nutritional indices neither in the supplemented nor in the placebo-control groups (p > 0.05). Conclusions: Fish oil and wheat germ oil combination did not produce significant effects on serum homocysteine levels and nutritional indices of hemodialysis patients.

Sign in / Sign up

Export Citation Format

Share Document