title: Effect of n-3 fatty acids on markers of brain injury and incidence of sepsis-associated delirium in septic patients.
abstract: BACKGROUND
  Data regarding immunomodulatory effects of parenteral n-3 fatty acids in sepsis are conflicting. In this study, the effect of administration of parenteral n-3 fatty acids on markers of brain injury, incidence of sepsis-associated delirium, and inflammatory mediators in septic patients was investigated.
  
  
  METHODS
  Fifty patients with sepsis were randomized to receive either 2 ml/kg/day of a lipid emulsion containing highly refined fish oil (equivalent to n-3 fatty acids 0.12 mg/kg/day) during 7 days after admission to the intensive care unit or standard treatment. Markers of brain injury and inflammatory mediators were measured on days 1, 2, 3 and 7. Assessment for sepsis-associated delirium was performed daily. The primary outcome was the difference in S-100β from baseline to peak level between both the intervention and the control group, compared by t-test. Changes of all markers over time were explored in both groups, fitting a generalized estimating equations model.
  
  
  RESULTS
  Mean difference in change of S-100β from baseline to peak level was 0.34 (95% CI: -0.18-0.85) between the intervention and control group, respectively (P = 0.19). We found no difference in plasma levels of S-100β, neuron-specific enolase, interleukin (IL)-6, IL-8, IL-10, and C-reactive protein between groups over time. Incidence of sepsis-associated delirium was 75% in the intervention and 71% in the control groups (risk difference 4%, 95% CI -24-31%, P = 0.796).
  
  
  CONCLUSIONS
  Administration of n-3 fatty acids did not affect markers of brain injury, incidence of sepsis-associated delirium, and inflammatory mediators in septic patients.
authors.affiliation: Department for Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital of Basel, Basel, Switzerland.
authors.forename: C S
authors.initials: CS
authors.lastname: Burkhart
authors.forename: S
authors.initials: S
authors.lastname: Dell-Kuster
authors.forename: M
authors.initials: M
authors.lastname: Siegemund
authors.forename: H
authors.initials: H
authors.lastname: Pargger
authors.forename: S
authors.initials: S
authors.lastname: Marsch
authors.forename: S P
authors.initials: SP
authors.lastname: Strebel
authors.forename: L A
authors.initials: LA
authors.lastname: Steiner
mesh_terms: D000368:Aged; D015415:Biomarkers; D001925:Brain Damage, Chronic / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D002097:C-Reactive Protein / Q000032:analysis; D003693:Delirium / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D004655:Emulsions; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D015228:Hypertriglyceridemia / Q000139:chemically induced; D018836:Inflammation Mediators / Q000097:blood; D007378:Interleukins / Q000097:blood; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010751:Phosphopyruvate Hydratase / Q000097:blood; D064568:S100 Calcium Binding Protein beta Subunit / Q000097:blood; D018805:Sepsis / Q000097:blood / Q000150:complications*
chemical_list: D015415:Biomarkers; D004655:Emulsions; D015525:Fatty Acids, Omega-3; D005395:Fish Oils; D018836:Inflammation Mediators; D007378:Interleukins; D064568:S100 Calcium Binding Protein beta Subunit; D002097:C-Reactive Protein; D010751:Phosphopyruvate Hydratase