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. DESIGN: Prospective, multicenter, randomized, comparative, double-blind study. SETTING: Seventeen Spanish ICUs during 4 years. SUBJECTS: 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. INTERVENTIONS: 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. MEASUREMENTS AND MAIN 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.
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Prospective randomized studies including surgical patients admitted in the ICU have shown less morbidity in the fish oil group compared to other lipid emulsions.
“Prospective randomized studies including surgical patients admitted in the ICU for a period of their hospitalization have shown less morbidity in the fish oil group compared to other lipid emulsions(259, 260, 261, 262, 263, 264).”
From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [261]
Cites
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Serhan, C. N., Chiang, N., & Van Dyke, T. E. (2008) · Nature Reviews Immunology · doi:10.1038/nri2294 · Cited by 2,932 · see citing works
Barbosa, V. M., Miles, E. A., Calhau, C., Lafuente, E., & Calder, P. C. (2010) · Critical Care · doi:10.1186/cc8844 · Cited by 180 · see citing works
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ESPEN guideline on clinical nutrition in the intensive care unit.
Singer, P., Blaser, A. R., Berger, M. M., Alhazzani, W., Calder, P. C., Casaer, M. P., Hiesmayr, M., Mayer, K., Montejo, J. C., Pichard, C., et al. (2019) · Clinical Nutrition · doi:10.1016/j.clnu.2018.08.037 · Cited by 2,904 · see citing works
Fish Oil–Containing Lipid Emulsions in Adult Parenteral Nutrition: A Review of the Evidence
Abbasoglu, O., Hardy, G., Manzanares, W., & Pontes‐Arruda, A. (2019) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607117721907 · Cited by 30 · see citing works
- Authors
- Grau-Carmona, T., Bonet-Saris, A., García-de-Lorenzo, A., Sánchez-Alvarez, C., Rodríguez-Pozo, A., Acosta-Escribano, J., Miñambres, E., Herrero-Meseguer, J. I., & Mesejo, A.
- Affiliations
- Hospital General Universitario de Alicante Doctor Balmis (ES)
- Marqués de Valdecilla University Hospital (ES)
- Bellvitge University Hospital (ES)
- Hospital Clínico Universitario de Valencia (ES)
- ORCID
- Miñambres, Eduardo
- Venue
- Critical Care Medicine
- Published
- 2015-01
- Volume
- 43
- Issue
- 1
- Pages
- 31-39
- ISSN
- 0090-3493 (ISSN-L)
- OpenAlex
- W2081309318
- Cited by
- 100
- References
- 2
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 5 · 2023: 3 · 2022: 8 · 2021: 8 · 2020: 15 · 2019: 9 · 2018: 8 · 2017: 10 · 2016: 11 · 2015: 10 · 2014: 1
- FWCI
- 9.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Keywords
- omega-3 fatty acids, fish oil, lipid emulsions, nosocomial infections, critically ill patients, total parenteral nutrition, immunomodulation, length of hospital stay, mortality, intensive care
- MeSH terms
- Critical Care, Cross Infection, Double-Blind Method, Fat Emulsions, Intravenous, Female, Humans, Intensive Care Units, Length of Stay, Male, Middle Aged, Parenteral Nutrition, Total, Respiration, Artificial, Fatty Acids, Omega-3, Prevalence, Critical Illness, Hospital Mortality
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