Perioperative administration of parenteral fish oil supplements in a routine clinical setting improves patient outcome after major abdominal surgery.
OBJECTIVE
It is hypothesized that provision of pre- and/or postoperative omega-3 fatty acids to surgical patients in clinical routine improves clinical outcome.


METHODS
Retrospective evaluation of a 2-year-longitudinal data base of ICU patients (n=249) elected for major abdominal surgery. Group I (n=110): postoperative standard parenteral nutrition (1.2 g amino acids, 0.3 g glutamine dipeptide, 0.6 g lipids, 4 g/kg glucose; energy ratio glucose to lipid 2:1); group II (n=86): part of postoperative lipid emulsion replaced by fish oil; group III (n=53): in addition 2-3 days preoperative fish oil supplementation (max. 100 ml/d).


RESULTS
A decrease in mortality was observed in group III compared to group I (P=0.02). The number of patients requiring mechanical ventilation was lower with perioperative fish oil (n=34 in groups I and II. 10 in III, P<0.05). The number of days in ICU was not different (group I: 7.6 days, group II: 7.0, group III: 7.3), the length of hospital stay was shorter in group I (group I: 29.2 days, group II: 24.9, group III: 22.2, P<0.05 vs I).


CONCLUSIONS
In a retrospective evaluation, perioperative provision of parenteral fish oil (ca. 10 g/day) beneficially influences patient outcome probably by modulating the immune response.
Tsekos
Evangelos
E
Department of Anesthesiology and Intensive Care, Krankenhaus der Barmherzigen Brüder, Munich, Germany.
Reuter
Clemens
C
Stehle
Peter
P
Boeden
Gerhard
G
D000005:Abdomen / Q000601:surgery*; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage*; D006801:Humans; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010289:Parenteral Nutrition, Total / Q000379:methods*; D019990:Perioperative Care / Q000379:methods*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D016896:Treatment Outcome
D005395:Fish Oils