Are three different lipid combinations effective on the immune system in sepsis patients?

Abstract

Objective: We aimed to to analyze the effect of the 3 different parenteral nutritions (MCT/LCT (long and midium chain fatty acids), LCT with omega-9 (ω-9) and MCT/LCT with ω-3 and ω-9 on the inflamatory cytokine levels in sepsis patients. This is the first study from the Southern part of Turkey. Patients and Methods: We included 30 patients, diagnosed with sepsis and took total parenteral nutrition in this study. Patients were divided into 3 randomized groups in terms of what parenteral nutrition have been taken. (Group A, B and C) Blood samples were taken and TNF-α, IL-1, IL-6 and IL-8 levels were evaluated. Adverse effects were recorded. TNF-α, IL-1β, IL-6, and IL-8 levels of were analyzed by ELISA method and each sample were studied in dublicate. Results: The median age of the patients included in the study was 52 and 24 (80%) of them were male. The SOFA score was 5 in study group. We examined IL-1, IL-6, IL-8 and TNF-α distribution on the day of the first, third and fifth days depending on time. The inflamatory cytokine levels were not found statistically significant (p > 0.05) when we compared the study groups via 3 different parenteral nutritions. Conclusion: When we compare MCT/LCT, LCT/ω-9 and MCT/LCT, ω-3, ω-9 which are given as a component of total parenteral nutrition we concluded that there was no superiority to others in terms of proinflamatory cytokin levels in sepsis and they didn’t increase proinflamatory cytokins. There is a need for more randomized controlled studies investigating the effect of lipids on the course of the disease in sepsis patients who cannot receive enteral nutrition and require TPN support.