title: Pre-treatment with an intravenous lipid emulsion containing fish oil (eicosapentaenoic and docosahexaenoic acid) decreases inflammatory markers after open-heart surgery in infants: a randomized, controlled trial.
abstract: OBJECTIVE
  This study assessed the effects of administering a lipid emulsion containing eicosapentaenoic and docosahexaenoic acid before and after open-heart surgery on cytokine production and length of hospital stay in infants.
  
  
  METHODS
  Thirty-two infants (40 ± 2.3 weeks gestational age; 10.6 days at time of surgery) undergoing open-heart surgery with cardiopulmonary bypass were randomized to receive an intravenous lipid emulsion with (treatment) or without (control) eicosapentaenoic and docosahexaenoic acid in this prospective, randomized, double-blind, controlled trial.
  
  
  RESULTS
  Mean plasma TNF-α concentration was significantly (p = 0.003) lower in the treatment (5.9 pg/mL) compared to the control group (14.8 pg/mL). In infants without sepsis, plasma TNF-α did not differ according to treatment, however when sepsis developed, mean plasma TNF-α was 21.1 pg/mL and 1.5 pg/mL (p = 0.0007) in control and treatment groups, respectively. Plasma TNF-α was positively correlated with length of hospital stay in the control group (p = 0.01), and negatively correlated with length of stay in the treatment group (p = 0.004), with a significant time by treatment interaction (p = 0.02).
  
  
  CONCLUSIONS
  Providing a lipid emulsion containing eicosapentaenoic and docosahexaenoic acid reduces TNF-α concentrations in infants undergoing open-heart surgery. Lipid emulsions containing eicosapentaenoic and docosahexaenoic acid may ameliorate the inflammatory response among critically ill infants.
authors.affiliation: Nutrition Service, Alberta Health Services, Edmonton Area, Canada. bodil.larsen@albertahealthservices.ca
authors.forename: Bodil M K
authors.initials: BM
authors.lastname: Larsen
authors.forename: Laksiri A
authors.initials: LA
authors.lastname: Goonewardene
authors.forename: Ari R
authors.initials: AR
authors.lastname: Joffe
authors.forename: John E
authors.initials: JE
authors.lastname: Van Aerde
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Field
authors.forename: Dana Lee
authors.initials: DL
authors.lastname: Olstad
authors.forename: Michael T
authors.initials: MT
authors.lastname: Clandinin
mesh_terms: D000416:Alberta; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D015331:Cohort Studies; D004281:Docosahexaenoic Acids / Q000008:administration & dosage / Q000009:adverse effects / Q000032:analysis / Q000627:therapeutic use; D004311:Double-Blind Method; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000032:analysis / Q000627:therapeutic use; D005217:Fat Emulsions, Intravenous / Q000009:adverse effects / Q000032:analysis / Q000627:therapeutic use*; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D016867:Immunocompromised Host; D007231:Infant, Newborn; D018836:Inflammation Mediators / Q000097:blood*; D007902:Length of Stay; D008297:Male; D011182:Postoperative Care; D011183:Postoperative Complications / Q000097:blood / Q000276:immunology / Q000517:prevention & control* / Q000628:therapy; D011300:Preoperative Care; D018805:Sepsis / Q000097:blood / Q000276:immunology / Q000517:prevention & control / Q000628:therapy; D013024:Soybean Oil / Q000009:adverse effects / Q000032:analysis / Q000627:therapeutic use
chemical_list: D005217:Fat Emulsions, Intravenous; D005395:Fish Oils; D018836:Inflammation Mediators; D004281:Docosahexaenoic Acids; D013024:Soybean Oil; D015118:Eicosapentaenoic Acid