Document Detail

Omega-3 vs. omega-6 lipid emulsions exert differential influence on neutrophils in septic shock patients: impact on plasma fatty acids and lipid mediator generation.
MedLine Citation:
PMID:  12897994     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To compare the effects of a conventional omega-6 lipid infusion and a fish oil based (omega-3) lipid infusion for parenteral nutrition on neutrophil function, lipid mediators, and plasma free fatty acids. DESIGN AND SETTING: Open-label, randomized, pilot study in a university hospital medical intensive care unit and experimental laboratory. PATIENTS AND PARTICIPANTS: Ten patients with septic shock and eight healthy controls. INTERVENTIONS: Patients (five per group) requiring parenteral nutrition received intravenously either a omega-3 or a omega-6 lipid emulsion for a 10-day period. MEASUREMENTS AND RESULTS: At baseline levels of plasma free fatty acids were elevated several-fold, including high concentrations of the omega-6 lipid precursor arachidonic acid (AA). Neutrophils isolated from septic patients displayed markedly reduced responsiveness to ex vivo stimulation, including lipid mediator generation [leukotrienes (LT), PAF], respiratory burst, and phosphoinositide hydrolysis signaling. Under the omega-6 lipid infusion regimen abnormalities in plasma free fatty acids and impairment of neutrophil functions persisted or worsened. In contrast, a rapid switch in the plasma free fatty acid fraction to predominance of the omega-3 acids eicosapentaenoic acid and docosahexaenoic acid over AA occurred in response to omega-3 lipid infusion. LTB(5), in addition to LTB(4), appeared upon neutrophil stimulation originating from these patients, and neutrophil function was significantly improved in the omega-3 lipid group. CONCLUSIONS: omega-3 vs. omega-6 lipid emulsions differentially influence the plasma free fatty acid profile with impact on neutrophil functions. Lipid-based parenteral nutrition in septic patients may thus exert profound influence on sequelae and status of immunocompetence and inflammation.
Konstantin Mayer; Christine Fegbeutel; Katja Hattar; Ulf Sibelius; Hans-Joachim Krämer; Kai-Uwe Heuer; Bettina Temmesfeld-Wollbrück; Stephanie Gokorsch; Friedrich Grimminger; Werner Seeger
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2003-07-25
Journal Detail:
Title:  Intensive care medicine     Volume:  29     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-09-08     Completed Date:  2004-03-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1472-81     Citation Subset:  IM    
Department of Internal Medicine, Justus Liebig University, Klinikstrasse 36, Giessen, Germany.
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MeSH Terms
Fat Emulsions, Intravenous / administration & dosage*
Fatty Acids, Nonesterified / blood*
Fatty Acids, Omega-3 / administration & dosage*
Fatty Acids, Omega-6 / administration & dosage*
Fish Oils / administration & dosage
Leukotrienes / metabolism
Middle Aged
Neutrophils / metabolism*
Phosphatidylinositols / metabolism
Pilot Projects
Platelet Activating Factor / metabolism
Shock, Septic / metabolism,  therapy*
Superoxides / metabolism
Thromboxanes / metabolism
Reg. No./Substance:
0/Fat Emulsions, Intravenous; 0/Fatty Acids, Nonesterified; 0/Fatty Acids, Omega-3; 0/Fatty Acids, Omega-6; 0/Fish Oils; 0/Leukotrienes; 0/Phosphatidylinositols; 0/Platelet Activating Factor; 0/Thromboxanes; 11062-77-4/Superoxides

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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