Abstract
Abstract: Background and Objective: Surgery can increase morbidity and mortality due to the production of proinflammatory cytokines, such as interleukin (IL)-6 and tumor necrosis factor (TNF)-α. Intravenous fish oil-enriched lipid emulsion (FOLE) contains ω-3, which can reduce the release of proinflammatory cytokines. The influence of FOLE compared to that of the standard medium chain triglyceride (MCT)/long chain triglyceride (LCT) emulsion on the inflammatory response in children post gastrointestinal surgery has never been studied. The current study was designed to explain the influence of FOLE on the inflammatory response in children post gastrointestinal surgery. Materials and Methods: A randomized controlled trial was conducted in August 2018-January 2019 at Dr. Soetomo Hospital in children post gastrointestinal surgery due to esophageal and intestinal atresia that requires parenteral nutrition for at least 3 days. The samples were divided randomly into MCT/LCT and FOLE groups. Laboratory and cytokine parameters were examined before and at 3 days after surgery. Results: Among all patients, 7/14 were male and 7/14 received FOLE. There were no significant differences in Hb, leukocyte, CRP, albumin, SGOT and SGPT levels in either group. The difference in IL-6 levels was significant between the two groups before surgery (p = 0.048), at 3 days after surgery (p = 0.013) and in changes within 3 days (p = 0.003). TNF-α levels were not significantly different compared to MCT/LCT at day 3 post surgery (p = 0.482). Conclusion: FOLE, compared to standard emulsions, can decrease IL-6 in postoperative children.
Highlights
Background and ObjectiveSurgery can increase morbidity and mortality due to the production of proinflammatory cytokines, such as interleukin (IL)-6 and tumor necrosis factor (TNF)-α
Conventionally used in Parenteral nutrition (PN), contains only soybean oil, which is rich in linoleic acid, ω-6 fatty acids, or a 50:50 mix from vegetable oil rich in medium chain triglyceride (MCT)/long chain triglyceride (LCT)
Fish oil is a source of long chain ω-3 polyunsaturated fatty acids (PUFAs), including eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA)
Summary
Surgery can increase morbidity and mortality due to the production of proinflammatory cytokines, such as interleukin (IL)-6 and tumor necrosis factor (TNF)-α. Intravenous fish oil-enriched lipid emulsion (FOLE) contains ω-3, which can reduce the release of proinflammatory cytokines. The influence of FOLE compared to that of the standard medium chain triglyceride (MCT)/long chain triglyceride (LCT) emulsion on the inflammatory response in children post gastrointestinal surgery has never been studied. The current study was designed to explain the influence of FOLE on the inflammatory response in children post gastrointestinal surgery
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