title: A randomized controlled trial investigating the effects of parenteral fish oil on survival outcomes in critically ill patients with sepsis: a pilot study.
abstract: BACKGROUND
  Death from sepsis in the intensive care unit (ITU) is frequently preceded by the development of multiple organ failure as a result of uncontrolled inflammation. Treatment with ω-3 has been demonstrated to attenuate the effects of uncontrolled inflammation and may be clinically beneficial.
  
  
  METHODS
  A randomized control trial investigating the effects of parenteral ω-3 was carried out. Consecutive patients diagnosed with sepsis were entered into the study and randomized to receive either parenteral ω-3 or standard medical care only. The primary outcome measure was a reduction in organ dysfunction using the Sequential Organ Failure Assessment (SOFA) score as a surrogate marker. The secondary outcome measures were mortality, length of stay, mean C-reactive protein (CRP), and days free of organ dysfunction/failure.
  
  
  RESULTS
  Sixty patients were included in the study. The baseline demographics were matched for the two cohorts. Patients treated with parenteral ω-3 were associated with a significant reduction in new organ dysfunction (Δ-SOFA 2.2 ± 2.2 vs. 1.0 ± 1.5, P = .005 and maximum-SOFA 10.1 ± 4.2 vs. 8.1 ± 3.2, P = .041) and maximum CRP (186.7 ± 78 vs. 141.5 ± 62.6, P = .019). There was no significant reduction in the length of stay between cohorts. Patients treated with ω-3 in the strata of less severe sepsis had a significant reduction in mortality (P = .042).
  
  
  CONCLUSIONS
  The treatment of critically ill septic patients with parenteral ω-3 is safe. It is associated with a significant reduction in organ dysfunction. It may be associated with a reduction in mortality in patients with less severe sepsis.
authors.affiliation: University Hospitals of Leicester, Leicester, UK tch2@doctors.org.uk.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Hall
authors.affiliation: University Hospitals of Leicester, Leicester, UK.
authors.forename: Dilraj K
authors.initials: DK
authors.lastname: Bilku
authors.affiliation: University Hospitals of Leicester, Leicester, UK.
authors.forename: Dhya
authors.initials: D
authors.lastname: Al-Leswas
authors.affiliation: University Hospitals of Leicester, Leicester, UK.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Neal
authors.affiliation: University Hospitals of Leicester, Leicester, UK.
authors.forename: Cindy
authors.initials: C
authors.lastname: Horst
authors.affiliation: University Hospitals of Leicester, Leicester, UK.
authors.forename: Jill
authors.initials: J
authors.lastname: Cooke
authors.affiliation: University Hospitals of Leicester, Leicester, UK.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Metcalfe
authors.affiliation: University Hospitals of Leicester, Leicester, UK.
authors.forename: Ashley R
authors.initials: AR
authors.lastname: Dennison
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D015525:Fatty Acids, Omega-3 / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D005395:Fish Oils; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D010288:Parenteral Nutrition; D010865:Pilot Projects; D018805:Sepsis / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000628:therapy*
chemical_list: D015525:Fatty Acids, Omega-3; D005395:Fish Oils; D002097:C-Reactive Protein
keywords: critical illness; fish oil; intensive care; randomized controlled trial; sepsis; ω-3