title: Influence of n-3 polyunsaturated fatty acids enriched lipid emulsions on nosocomial infections and clinical outcomes in critically ill patients: ICU lipids study.
abstract: OBJECTIVE
  n-3 polyunsaturated fatty acids (contained in fish oil) have been shown to beneficially influence infection rate and clinical outcomes in surgical patients probably due to their immunomodulatory action. In contrast, study results of fish oil administration in critically ill patients are controversial. The aim of this study was to investigate the effects of n-3 polyunsaturated fatty acids on the prevalence of nosocomial infections and clinical outcomes in medical and surgical critically ill patients.
  
  
  METHODS
  Prospective, multicenter, randomized, comparative, double-blind study.
  
  
  METHODS
  Seventeen Spanish ICUs during 4 years.
  
  
  METHODS
  A total of 159 medical and surgical intensive care patients with Acute Physiology and Chronic Health Evaluation II score more than or equal to 13, expected to require total parenteral nutrition for at least 5 days.
  
  
  METHODS
  Patients received total parenteral nutrition prepared either with a lipid emulsion containing 10% fish oil or a fish oil-free lipid emulsion. The prevalence of nosocomial infections was detected during 28 days of ICU stay. Patients were followed 6 months after discharge from the ICU for length of hospital stay, hospital mortality, and 6-month mortality.
  
  
  RESULTS
  The number of patients with nosocomial infections was significantly reduced in the fish oil-receiving group (21.0% vs 37.2%, p = 0.035) and the predicted time free of infection was prolonged (21 ± 2 vs 16 ± 2 d, p = 0.03). No significant differences were detected for ICU, hospital, and 6-month mortality.
  
  
  CONCLUSIONS
  The results show that administration of n-3 polyunsaturated fatty acids reduces the risk of nosocomial infections and increases the predicted time free of infections in critically ill medical and surgical patients. The administration of n-3 polyunsaturated fatty acids was safe and well tolerated.
authors.affiliation: 1Intensive Care Unit, Hospital Universitario Doce de Octubre, Madrid, Spain. 2Intensive Care Unit, Clinica Girona, Girona, Spain. 3Intensive Care Unit, Hospital Universitario La Paz, Madrid, Spain. 4Intensive Care Unit, Hospital General Universitario Reina Sofía, Murcia, Spain. 5Intensive Care Unit, Hospital Universitari Arnau de Vilanova, Lleida, Spain. 6Intensive Care Unit, Hospital General Universitario de Alicante, Alicante, Spain 7Intensive Care Unit, Hospital Universitario Marqués de Valdecilla, Santander, Spain. 8Intensive Care Unit, Hospital Universitario de Bellvitge, Barcelona, Spain. 9Intensive Care Unit, Hospital Clinico Universitario, Valencia, Spain.
authors.forename: Teodoro
authors.initials: T
authors.lastname: Grau-Carmona
authors.forename: Alfonso
authors.initials: A
authors.lastname: Bonet-Saris
authors.forename: Abelardo
authors.initials: A
authors.lastname: García-de-Lorenzo
authors.forename: Carmen
authors.initials: C
authors.lastname: Sánchez-Alvarez
authors.forename: Angel
authors.initials: A
authors.lastname: Rodríguez-Pozo
authors.forename: José
authors.initials: J
authors.lastname: Acosta-Escribano
authors.forename: Eduardo
authors.initials: E
authors.lastname: Miñambres
authors.forename: Jose Ignacio
authors.initials: JI
authors.lastname: Herrero-Meseguer
authors.forename: Alfonso
authors.initials: A
authors.lastname: Mesejo
mesh_terms: D003422:Critical Care / Q000379:methods; D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D004311:Double-Blind Method; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use*; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000379:methods / Q000401:mortality; D015995:Prevalence; D012121:Respiration, Artificial / Q000706:statistics & numerical data
chemical_list: D005217:Fat Emulsions, Intravenous; D015525:Fatty Acids, Omega-3