Enteral fish oil in critical illness: perspectives and systematic review
Abstract
PURPOSE OF REVIEW: To summarize recent research addressing the role of enteral fish oil supplementation in critical illness. RECENT FINDINGS: A number of new multicenter trials examining both the use of fish oil given as a supplement to enteral nutrition support and given as a separate bolus, independent of nutrition delivery, have recently been reported. SUMMARY: Mechanistic data suggest that administration of fish oil may help attenuate the systemic inflammatory response and allow for appropriate resolution of inflammation in critically ill patients. Recent data indicate that enteral fish oil given as a continuous infusion as part of complete nutrition improves outcome in critically ill patients, especially those with acute lung injury/acute respiratory distress syndrome. In contrast, the bolus administration of fish oil cannot be recommended as clinically beneficial in acute lung injury/acute respiratory distress syndrome patients. Recent trials indicate that pharmacologically administered nutrients should be studied in the same manner as other new drugs, with appropriate attention to early dosing trials, proper pre-enrollment patient selection, and understanding of the role of concomitant protein/calorie nutrition. More research continues to be needed to optimize the proper patient, dose, and timing of administration for enteral fish oil therapy in the ICU.
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Glenn and Wischmeyer found that continuous administration of omega-3 FAs improved length of stay and length of ventilation; in contrast, bolus administration had no advantage.
“Glenn and Wischmeyer [88] analyzed separately the studies administering omega-3 FAs as a bolus or in a continuous manner and found that continuous administration improved length of stay and length of ventilation; in contrast, bolus administration had no advantage.”
From ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit (2023) · cites this paper as [88]
Cites
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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
ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit
Singer, P., Blaser, A. R., Berger, M. M., Calder, P. C., Casaer, M., Hiesmayr, M., Mayer, K., Montejo-Gonzalez, J. C., Pichard, C., Preiser, J.-C., et al. (2023) · Clinical Nutrition · doi:10.1016/j.clnu.2023.07.011 · Cited by 793 · see citing works
- Authors
- Glenn, J. O. H., & Wischmeyer, P. E.
- Affiliations
- University of Colorado Anschutz (US)
- Corresponding author
- Wischmeyer, Paul E.
- ORCID
- Wischmeyer, Paul E.
- Venue
- Current Opinion in Clinical Nutrition and Metabolic Care
- Published
- 2014-03
- Volume
- 17
- Issue
- 2
- Pages
- 116-123
- ISSN
- 1363-1950 (ISSN-L)
- OpenAlex
- W2001338222
- Cited by
- 21
- References
- 3
- Citations by year
- 2023: 2 · 2021: 3 · 2020: 4 · 2019: 1 · 2018: 2 · 2017: 3 · 2016: 1 · 2015: 2 · 2014: 3
- FWCI
- 2.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Opinion in Clinical Nutrition & Metabolic Care (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 › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Keywords
- critical illness, enteral nutrition, acute lung injury, acute respiratory distress syndrome, systemic inflammatory response, anti-inflammatory activity, continuous infusion, ICU nutrition, protein and calorie intake
- MeSH terms
- Critical Care, Enteral Nutrition, Fish Oils, Humans, Nutritional Status, Respiratory Distress Syndrome, Fatty Acids, Omega-3, Critical Illness, Systemic Inflammatory Response Syndrome, Dietary Supplements
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