Fish oil after abdominal aorta aneurysm surgery.
OBJECTIVE
Fish oil (FO) may attenuate the inflammatory response after major surgery such as abdominal aortic aneurysm (AAA) surgery. We aimed at evaluating the clinical impact and safety aspects of a FO containing parenteral nutrition (PN) after AAA surgery.


METHODS
Intervention consisted in 4 days of either standard (STD: Lipofundin medium-chain triglyceride (MCT): long-chain triglyceride (LCT)50%-MCT50%) or FO containing PN (FO: Lipoplus: LCT40%-MCT50%-FO10%). Energy target were set at 1.3 times the preoperative resting energy expenditure by indirect calorimetry. Blood sampling on days 0, 2, 3 and 4. Glucose turnover by the (2)H(2)-glucose method. Muscle microdialysis.


METHODS
maximal daily T degrees, intensive care unit (ICU) and hospital stay.


RESULTS
Both solutions were clinically well tolerated, without any differences in laboratory safety parameters, inflammatory, metabolic data, or in organ failures. Plasma tocopherol increased similarly; with FO, docosahexaenoic and eicosapentaenoic acid increased significantly by day 4 versus baseline or STD. To increased postoperatively, with a trend to lower values in FO group (P=0.09). After FO, a trend toward shorter ICU stay (1.6+/-0.4 versus 2.3+/-0.4), and hospital stay (9.9+/-2.4 versus 11.3+/-2.7 days: P=0.19) was observed.


CONCLUSIONS
Both lipid emulsions were well tolerated. FO-PN enhanced the plasma n-3 polyunsaturated fatty acid content, and was associated with trends to lower body temperature and shorter length of stay.
Berger
M M
MM
Department of Intensive Care Medicine, CHUV, Lausanne, Switzerland. mette.berger@chuv.ch
Tappy
L
L
Revelly
J P
JP
Koletzko
B V
BV
Gepert
J
J
Corpataux
J M
JM
Cayeux
M C
MC
Chiolero
R L
RL
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001786:Blood Glucose / Q000378:metabolism; D001831:Body Temperature; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D005395:Fish Oils / Q000627:therapeutic use*; D006801:Humans; D007773:Lactates / Q000378:metabolism; D008055:Lipids / Q000097:blood*; D008297:Male; D017551:Microdialysis; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000378:metabolism; D010288:Parenteral Nutrition; D010743:Phospholipids / Q000627:therapeutic use*; D011182:Postoperative Care; D013012:Sorbitol / Q000627:therapeutic use*
D001786:Blood Glucose; D004338:Drug Combinations; D005395:Fish Oils; D007773:Lactates; D008055:Lipids; D010743:Phospholipids; C008288:Lipofundin; D013012:Sorbitol