Nutritional armor for the injured warfighter: omega-3 fatty acids in surgery, trauma, and intensive care.
Nutrients have traditionally been viewed as a means to provide basic energy for cellular homeostasis and amino acids for protein synthesis in all humans. Young, healthy men and women in the military today are presumed to be well nourished and mentally and physically fit to perform their duties in austere environments. Exposure to high-intensity projectiles, blast injuries, and other wounds of war, however, is an everyday occurrence during deployment that potentially challenges all homeostatic mechanisms. After sustaining such devastating injuries, critically ill, surgical, and trauma patients are in a constant dynamic state between the systemic inflammatory response syndrome (and compensatory anti-inflammatory response syndrome. Compelling evidence supports both immune and metabolic response modulation by specific nutrients, including omega-3 fatty acids, primarily eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). The concept of providing nutrients as therapeutic rather than supportive agents to meet the basic cellular caloric and metabolic demands requires a major paradigm shift. Although the exact route and dose of these metabolically active lipids has yet to be determined, data from large clinical studies of cellular ex-vivo experiments in patients support the liberal use of eicosapentaenoic acid and docosahexaenoic acid in the setting of trauma, surgery, and intensive care.
Madigan Army Medical Center, 9040 Jackson Avenue, Tacoma, WA 98431.
Mary S
MS
McCarthy
University of Iowa Medical Center, 200 Hawkins Drive, Iowa City, IA 52242.
Brian B
BB
Morgan
University of Iowa Medical Center, 200 Hawkins Drive, Iowa City, IA 52242.
John T
JT
Heineman
Department of Surgery, Oregon Health and Science University, 3181 Sam Jackson Park Road, Portland, OR 97239.
Robert G
RG
Martindale
D003422:Critical Care; D016638:Critical Illness; D004281:Docosahexaenoic Acids / Q000627:therapeutic use; D015118:Eicosapentaenoic Acid / Q000627:therapeutic use; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D006801:Humans; D008889:Military Personnel; D044623:Nutrition Therapy / Q000379:methods*; D009751:Nutritional Requirements; D014481:United States; D014857:Warfare; D014947:Wounds and Injuries / Q000601:surgery* / Q000628:therapy
D015525:Fatty Acids, Omega-3; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid