title: Comparative effects of olive oil-based and soyabean oil-based emulsions on infection rate and leucocyte count in critically ill patients receiving parenteral nutrition.
abstract: Soyabean oil-based emulsions high in linoleic acid used in parenteral nutrition (PN) could interfere with immune function and may increase the risk of septic complications. Olive oil-based emulsions, high in oleic acid, could have fewer immune effects. We compared the effects of a soyabean oil-based emulsion v. an olive oil-based emulsion on infection rate, appearance of new infection episodes, leucocyte count (peak and evolution), acute-phase proteins, and major health outcomes in intensive care unit (ICU) adult patients receiving PN. The study was designed as an observational, retrospective, single-centre, cohort study in a general ICU. Patients in the SOYA cohort (n 16) received a soyabean oil-based emulsion and patients in the OLIVE cohort (n 23), an olive oil-based emulsion. Both cohorts had similar basal characteristics and received a similar energy load. The SOYA cohort received an oleic acid:linoleic acid ratio of 0.43 and the OLIVE cohort 2.99 (P < 0.001). No differences were observed in infection rate and appearance, acute-phase proteins, and major health outcomes. At the end of PN, blood leucocyte count decreased by 3.25 x 109 cells/l in the SOYA cohort and increased by 4.51 x 109 cells/l in the OLIVE cohort from baseline values (P = 0.036). Peak leucocyte count presented a trend for a higher value in the OLIVE cohort v. the SOYA cohort (18.86 v. 15.28 x 109 cells/l; P = 0.078). The use of an olive oil-based emulsion in PN had no effect on infection, acute-phase proteins, major health outcomes, and presented higher leucocyte count at the end of PN and a trend to higher peak leucocyte count when compared with soyabean oil-based emulsion in ICU patients.
authors.affiliation: Pharmacy Department Hospital del Mar, Passeig Marítim, 25-29, 08003 Barcelona, Spain. Fmateu@imas.imim.es
authors.forename: Javier
authors.initials: J
authors.lastname: Mateu-de Antonio
authors.forename: Santiago
authors.initials: S
authors.lastname: Grau
authors.forename: Sonia
authors.initials: S
authors.lastname: Luque
authors.forename: Mónica
authors.initials: M
authors.lastname: Marín-Casino
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Albert
authors.forename: Esther
authors.initials: E
authors.lastname: Ribes
mesh_terms: D000209:Acute-Phase Proteins / Q000032:analysis; D003422:Critical Care / Q000379:methods*; D005217:Fat Emulsions, Intravenous / Q000627:therapeutic use*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D007958:Leukocyte Count; D019787:Linoleic Acid / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D019301:Oleic Acid / Q000008:administration & dosage; D000069463:Olive Oil; D010289:Parenteral Nutrition, Total / Q000379:methods*; D010938:Plant Oils; D012189:Retrospective Studies; D018805:Sepsis / Q000178:diet therapy / Q000276:immunology* / Q000382:microbiology; D013024:Soybean Oil
chemical_list: D000209:Acute-Phase Proteins; D005217:Fat Emulsions, Intravenous; D000069463:Olive Oil; D010938:Plant Oils; D019301:Oleic Acid; D013024:Soybean Oil; D019787:Linoleic Acid