Fish oil-containing lipid emulsions in patients with sepsis

Konstantin Mayer,Werner Seeger

doi:10.1186/cc8882

Abstract

Lipid emulsions based on soybean oil have been an integral part of parenteral nutrition supplying n-6 fatty acids, with possible negative effects in critically ill patients. Newer lipid emulsions supply less n-6 fatty acids. In addition, fish oil-based lipids may be included in the lipid component of parenteral nutrition. While clinical benefits of lipid emulsions with a reduced fraction in n-6 lipids and the addition of fish oil have been described in postoperative patients, data are less clear in critically ill or septic patients. Recent data suggest that beneficial effects may be achieved when used early but clearly more data are needed to come to a definitive conclusion. The present commentary will highlight current data in critically ill and septic patients and the use of fish oil as a part of parenteral nutrition.

Highlights

Lipid emulsions based on soybean oil have been an integral part of parenteral nutrition supplying n-6 fatty acids, with possible negative effects in critically ill patients
Parenteral nutrition is often used in critically ill patients when enteral nutrition is not sufficient or is not fully installed
A larger single-centre trial in 166 critically ill patients comparing a lipid emulsion based on soy bean oil (SO) and mediumchain triglycerides (LCT/medium-chain triglycerides (MCT)) versus the same emulsion supplemented with fish oil (FO), failed to detect a clinical benefit [8]

Summary

Introduction

Lipid emulsions based on soybean oil have been an integral part of parenteral nutrition supplying n-6 fatty acids, with possible negative effects in critically ill patients. In critically ill patients and in animal models, a negative impact of these lipid emulsions has been described. Barbosa and colleagues report the effects of a new lipid emulsion on clinical and experimental parameters in patients with systemic inflammatory response syndrome and sepsis [1].

Results

Conclusion