Perioperative administration of parenteral fish oil supplements in a routine clinical setting improves patient outcome after major abdominal surgery

Abstract

Background & aims: It is hypothesized that provision of pre- and/or postoperative omega-3 fatty acids to surgical patients in clinical routine improves clinical outcome. Methods: Retrospective evaluation of a 2-year-longitudinal data base of ICU patients ( n=249) elected for major abdominal surgery. Group I ( n=110): postoperative standard parenteral nutrition (1.2 g amino acids, 0.3 g glutamine dipeptide, 0.6 g lipids, 4 g/kg glucose; energy ratio glucose to lipid 2:1); group II ( n=86): part of postoperative lipid emulsion replaced by fish oil; group III ( n=53): in addition 2–3 days preoperative fish oil supplementation (max. 100 ml/d). Results: A decrease in mortality was observed in group III compared to group I ( P=0.02). The number of patients requiring mechanical ventilation was lower with perioperative fish oil ( n=34 in groups I and II. 10 in III, P<0.05). The number of days in ICU was not different (group I: 7.6 days, group II: 7.0, group III: 7.3), the length of hospital stay was shorter in group I (group I: 29.2 days, group II: 24.9, group III: 22.2, P<0.05 vs I). Conclusions: In a retrospective evaluation, perioperative provision of parenteral fish oil (ca. 10 g/day) beneficially influences patient outcome probably by modulating the immune response.