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Impact of omega-3 fatty acids on mortality and length of hospital stay in severely ill patients: A-4

Heller, A. R.; Roessler, S.; Litz, R. J.; Gottschlich, B.; Heller, S. C.; Koch, T.

European Journal of Anaesthesiology: May 2005 - Volume 22 - Issue - p 1–2
ESA Best Abstract Prize Competition (BAPC)
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Department of Anaesthesiology and Intensive Care Med, University Hospital Carl Gustav Carus, Dresden, Germany

Background and Goal of Study: Supplementation with omega-3 fatty acids, exerts immune-modulating and organ-protective effects, even after short term infusion in both postoperative and critically ill patients (1,2).

Materials and Methods: After approval by the institutional Ethic Review Board we evaluated the effect different doses of fish oil (FO) emulsion (Omegaven-Fresenius-Kabi) on the clinical course of severely ill patients. Primary study end point was survival, secondary end points were length of hospital stay and use of antibiotics, with respect to the primary diagnosis. 661 Patients who received total parenteral nutrition (TPN) for at least 3 days from 82 German hospitals were enrolled in this prospective multicenter trial. The cohort was divided into 5 groups according to the administered FO dose.

Results and Discussions: The patients of this survey were 62 ± 17 years old (SAPS II 32 ± 14). TPN including FO had most favourable effects on survival, infection rates and length of stay when administered in doses between 0.1-0.2 g/kg/d. Diagnosis-related optimum FO doses are given in fig. The dose/kg/d of FO had 2 to 20 times higher impact on outcome parameters than the ratio of n3/n6 which is considered to be a major determinant of beneficial n3 effects in current literature.

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Conclusion: Fish oil administration may reduce mortality, antibiotic use, and length of hospital stay. Individual optimum FO doses and effect sizes are diagnosis-dependent.

Acknowledgements: The authors thank R. Koch and J. Novotny for their biomathematical advise.

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References:

1 Gadeck JE, et al. Crit Care Med 1999.
2 Heller AR, et al. Int J Cancer 2004.
© 2005 European Society of Anaesthesiology