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A Randomized Controlled Trial Investigating the Effects of Parenteral Fish Oil on Survival Outcomes in Critically Ill Patients With Sepsis
Author(s) -
Hall Thomas C.,
Bilku Dilraj K.,
AlLeswas Dhya,
Neal Christopher P.,
Horst Cindy,
Cooke Jill,
Metcalfe Matthew S.,
Dennison Ashley R.
Publication year - 2015
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607113518945
Subject(s) - medicine , sepsis , organ dysfunction , randomized controlled trial , sofa score , intensive care unit , parenteral nutrition , intensive care , intensive care medicine , gastroenterology
Death from sepsis in the intensive care unit (ITU) is frequently preceded by the development of multiple organ failure as a result of uncontrolled inflammation. Treatment with ω‐3 has been demonstrated to attenuate the effects of uncontrolled inflammation and may be clinically beneficial. Method: A randomized control trial investigating the effects of parenteral ω‐3 was carried out. Consecutive patients diagnosed with sepsis were entered into the study and randomized to receive either parenteral ω‐3 or standard medical care only. The primary outcome measure was a reduction in organ dysfunction using the Sequential Organ Failure Assessment (SOFA) score as a surrogate marker. The secondary outcome measures were mortality, length of stay, mean C‐reactive protein (CRP), and days free of organ dysfunction/failure. Results: Sixty patients were included in the study. The baseline demographics were matched for the two cohorts. Patients treated with parenteral ω‐3 were associated with a significant reduction in new organ dysfunction (Δ‐SOFA 2.2 ± 2.2 vs. 1.0 ± 1.5, P = .005 and maximum‐SOFA 10.1 ± 4.2 vs. 8.1 ± 3.2, P = .041) and maximum CRP (186.7 ± 78 vs. 141.5 ± 62.6, P = .019). There was no significant reduction in the length of stay between cohorts. Patients treated with ω‐3 in the strata of less severe sepsis had a significant reduction in mortality ( P = .042). Conclusion: The treatment of critically ill septic patients with parenteral ω‐3 is safe. It is associated with a significant reduction in organ dysfunction. It may be associated with a reduction in mortality in patients with less severe sepsis.